Suspect in UnitedHealthcare CEO shooting struggles with officers after arriving at court

The suspect in the killing of UnitedHealthcare's CEO struggled with deputies and shouted Tuesday while arriving for a court appearance in Pennsylvania, a day after he was arrested at a McDonald's and charged with murder.

Luigi Nicholas Mangione emerged from a patrol car, spun toward reporters and shouted something partly unintelligible referring to an "insult to the intelligence of the American people" while deputies pushed him inside.

Prosecutors were beginning to take steps to bring Mangione back to New York to face a murder charge while new details emerged about his life and how he was captured.

The 26-year-old Ivy League graduate from a prominent Maryland real estate family was charged with murder hours after he was arrested in the Manhattan killing of Brian Thompson, who led the United States' largest medical insurance company.

At the brief hearing, defence lawyer Thomas Dickey informed the court that Mangione will not waive extradition to New York but instead wants a hearing on the issue. Mangione was denied bail after prosecutors raised concerns about public safety and a potential flight risk.

Mangione, wearing an orange prison jumpsuit, mostly stared straight ahead at the hearing, occasionally consulting papers, rocking in his chair or looking back at the gallery. At one point, he began to speak to respond to the court discussion but was quieted by his lawyer.

"You can't rush to judgment in this case or any case," Dickey said afterward. "He's presumed innocent. Let's not forget that."

New York Gov. Kathy Hochul said Tuesday night on the social media platform X that she will sign a request for a governor's warrant "to ensure the suspect in the murder of Brian Thompson is held accountable in New York."

Mangione likely was motivated by his anger with what he called "parasitic" health insurance companies and a disdain for corporate greed, according to a law enforcement bulletin obtained by The Associated Press.

He wrote that the U.S. has the most expensive health-care system in the world and that profits of major corporations continue to rise while "our life expectancy" does not, the bulletin said, based on a review of his hand-written notes and social media posts.

Mangione called Ted Kaczynski — known as the Unabomber — a "political revolutionary" and may have found inspiration from the man who carried out a series of bombings while railing against modern society and technology, according to the police bulletin.

Mangione remained jailed in Pennsylvania, where he was initially charged with possession of an unlicensed firearm, forgery and providing false identification to police. Manhattan prosecutors have obtained an arrest warrant, a step that could help expedite his extradition from Pennsylvania.

Mangione was arrested in Altoona, Pa., about 370 kilometres west of New York City, after a McDonald's customer recognized him and notified an employee, authorities said.

Officers found him sitting at a back table, wearing a blue medical mask and looking at a laptop, according to a Pennsylvania police criminal complaint.