Taking a closer look at Mangione's medical issues

Sam Brock
New insights emerged about Mangione, including the pain he suffered as the result of a back injury.
A former acquaintance in Hawaii described a surfing accident that aggravated the injury, and a former high school friend reacted to the news that Mangione is a suspect.
Tracking the suspect's movements from slaying to courthouse


David K. Li
Phil Helsel
David K. Li and Phil Helsel
Mangione was seen near a Port Authority bus station 46 minutes after the shocking crime, New York police said, before he made his way to Pennsylvania, where he was eventually arrested.
Thompson was shot from behind outside the New York Hilton Midtown hotel last Wednesday as he was on his way to UnitedHealth Group’s investor conference, officials have said.
Police believe Mangione left the city, triggering an intense manhunt that led to his arrest at a McDonald’s in Altoona, Pennsylvania, days later. He evaded police for “several days” in Pennsylvania, authorities have said, and his exact whereabouts betweenthe morning ofthe shooting and his arrest remain a mystery.
See the full timeline here.
Brother of 'Unabomber' speaks out about Mangione, who reviewed his manifesto
Erik Ortiz
The brother of Ted Kaczynski, the domestic terrorist known as the "Unabomber," says that he hopes Mangione doesn't view his brother as a "key model"and that he is distressed that his brother's actions decades ago may motivate violence today.
Mangione had reviewed Kaczynski's "Industrial Society and Its Future," also known as "The Unabomber Manifesto," on the site Goodreads in January, rating it four stars.
"To the extent that he may have attributed at all to sort of normalizing or recasting the violent acts as beneficial to humanity is a terrible mistake,” David Kaczynski said of his brother.
"Many factors go into a person's motivation that they drastically act like this," David Kaczynski added of Thompson's killing, "and I hope my brother wasn't in a way a key model for him."
Read the full story here.
NYPD chief of detectives says investigators are looking at back injury
Phil Helsel
New York police investigators are looking at whether there is any connection between a back injury suffered by Mangione and the killing of United Healthcare’s CEO, the chief of detectives told Fox News.
NYPD Chief of Detectives Joseph Kenny said that according to Mangione's writings and his social media profile, he may have sustained a back injury in July 2023.
“He was posting an X-ray on his social media showing numerous screws being inserted into his spine. Some of the writings that he had, he was discussing the difficulty of sustaining that injury,” Kenny said on Fox News today.
“So we’re looking into whether or not the insurance industry either denied a claim from him or didn’t help him out to the fullest extent,” Kenny said.
A friend of Mangione’s who knew him from a Honolulu co-living community called Surfbreak said on MSNBC that Mangione suffered a back injury but that he remained positive.
Mangione’s attorney says judge should have set bail
Phil Helsel
Mangione’s attorney said a Pennsylvania judge should have set bail in some amount.
Attorney Thomas Dickey said that in Pennsylvania, bail can be denied in capital cases or when someone is charged with first-degree murder involving life without parole.
Mangione was arrested yesterday in that state on charges that include a weapons and a forgery count, but authorities in New York have charged him with murder. A Pennsylvania judge denied him bail yesterday.
“I think he was entitled to bail. And if the judge makes it $100 million or $10 billion or $100,000, he’s entitled to bail,” Dickey said.
New York Gov. Kathy Hochulsaid she will sign a warrant for Mangione's extradition to New York.
Valerie Castro
Various merchandise is being sold online glorifying Mangione. Ornaments, bracelets and T-shirts are among some of them.
Read the full story here.
Lawyer hopes Mangione's outburst outside court today was his last
Phil Helsel
Mangione's lawyer said he hoped today's shouted statement is his last one.
“Hopefully, there won’t be any more of that,” attorney Thomas Dickey told reporters.
Outside court, Mangione shouted, “It’s completely out of touch and an insult to the intelligence of the American people.”
Pennsylvania State Police have said that after Mangione was arrested in Altoona yesterday, he had initially talked to authorities but has since stopped.
Asked about Mangione’s emotional state, Dickey said anyone would experience a range of feelings.
“If you put yourself in, if you or a loved one were in that position — it’s a natural, I think, thing to go through many emotional states,” Dickey said.
“As far as him not talking, I’m going to be his lawyer, I’m going to do the talking,” he said.
Suspect deserves presumption of innocence, lawyer says
Phil Helsel
Mangione will plead not guilty to charges in Pennsylvania and is expected to do the same in New York on any murder charge, his lawyer said today.
“Listen, I haven’t seen any evidence that says he’s the shooter,” Mangione’s attorney in Pennsylvania, Thomas Dickey, told reporters.
Mangione, a suspect in Thompson’s killing, has not waived extradition from Pennsylvania to New York, meaning he could contest it.
“Remember, and this is not just a small thing: A fundamental concept of American justice is the presumption of innocence, and until you’re proven guilty beyond a reasonable doubt,” Dickey said.
Dickey said “I’ve seen zero evidence at this point” that Mangione is the shooter.
Mangione was arrested in Altoona yesterday and is charged forgery, possession of a weapon and other counts there. He is not charged with murder in Pennsylvania.
New York governor confirms she will sign extradition warrant
Josh Cradduck
New York Gov. Kathy Hochul said she is coordinating with prosecutors on a governor's warrant to extradite Mangione to New York to face charges in Thompson's killing.
Hochul promised she would sign a request for a warrant, which a Pennsylvania judge gave prosecutors 30 days to obtain, to ensure Mangione "is tried and held accountable."
"Public safety is my top priority, and I’ll do everything in my power to keep the streets of New York safe," Hochul said.
Unclear whether Mangione made the 'ghost gun' he was found with, officials say


Jonathan Dienst
Tom Winter
Jonathan Dienst and Tom Winter
Investigators are still trying to determine whether Mangione made the gun they allege he used to kill Thompson, two senior law enforcement officials briefed on the investigation told NBC News.
Law enforcement officials had said Mangione was found with what has been described as “ghost gun,” but the officials told NBC News it is unclear whether he made it himself or bought it or was given the firearm.
However, those officials said, there’s little doubt that the gun and the suppressor were both homemade.
White House condemns 'violence to combat any sort of corporate greed'
Doha Madani
White House press secretary Karine Jean-Pierre said the Biden administration condemns the “horrific” killing of Thompson.
“Violence to combat any sort of corporate greed is unacceptable,” Jean-Pierre told reporters at today’s news briefing. “We condemn violence in the strongest term.”
She declined to comment on the specifics of what Mangione reportedly wrote about the health care industry, instead expressing condolences to Thompson’s family and loved ones.
Jean-Pierre also declined to answer follow-up questions about whether health insurance companies treat people fairly, citing the ongoing enforcement investigation.
Mangione's friend says person he knew is 'incompatible' with an assassin



Katy Tur
Alicia Victoria Lozano
Katy Tur and Alicia Victoria Lozano
R.J. Martin met Mangione in 2022 when he applied to live at Surfbreak, a co-living community in Honolulu.
Martin, who owns Surfbreak, said Mangione passed a background check and struck him as a thoughtful, kind college graduate eager to take in Hawaii’s natural landscape and make new friends.
“He was always giving and considerate and thoughtful,” Martin said on MSNBC. “I remember cooking meals with him and joking around. He had a great sense of humor. We bonded over working out, over intellectual conversations. We had a book club.”
Martin said that even though he had suffered a back injury, Mangione remained outwardly positive. On occasion, he would discuss systemic problems facing the U.S., including corporate greed and a fraught health care system. But those conversations never seemed particularly dark or violent, Martin said.
“The young man that I got to know seems completely incompatible with an assassin,” he said.
Investigators probing whether Thompson was a 'symbolic takedown'


Tom Winter
Jonathan Dienst
Tom Winter and Jonathan Dienst
New York investigators are looking into whether Thompson was the target of a “symbolic takedown,”according to two senior law enforcement officials briefed on the matter.
Police are exploring the possibility that Thompson’s killing was a culmination of Mangione’s troubles and list of grievances in a fight against corporate “power games,” the officials said.
Investigators also said Mangione may have admired the attacks by Ted Kaczynski, known as the “Unabomber,” and alleged that he echoed his concerns about technological advancement.
Manhattan prosecutors will pursue warrant to extradite Mangione

Doha Madani
Gary Grumbach
Doha Madani and Gary Grumbach
Manhattan District Attorney Alvin Bragg’s office confirmed that prosecutors will seek a governor’s warrant to extradite Mangione, NBC New York reported today.
Mangione appeared in a Pennsylvania court today and fought his extradition to New York. He was denied bail on felony charges of forgery and carrying a firearm without a license.
After the hearing, Blair County District Attorney Peter Weeks told reporters that he does believe the New York charges take precedence, as “there is no more significant assault than homicide.”
“That doesn’t mean we’re getting rid of our charges,” he added.
Substack writer says he corresponded with Mangione about politics and health care costs
Daniel Arkin
Gurwinder Bhogal, a British freelance writer who publishes a Substack newsletter called The Prism, said he corresponded with Mangione from April to June. The two men talked about politics, philosophy and the cost of health care in the U.S., Bhogal said.
Bhogal said Mangione, a “founding member” of his subscription-based newsletter, appeared to hold a mix of left-wing and right-wing political views. The two men discussed the “gamification of society,” and Mangione expressed interest in the “ideology” of Ted Kaczynski, the domestic terrorist known as the “Unabomber.”
Mangione “disapproved” of Kaczynski’s deadly actions, Bhogal said, but “he shared his concerns about rampant consumerism gradually eroding our agency and alienating us from ourselves.”
“He expressed fears over smartphone addiction. Luigi asked me how to maximize agency in a world constantly trying to deprive us of it, so we also discussed that,” Bhogal said in an email. “Overall, the impression I got of him, besides his curiosity and kindness, was a deep concern for the future of humanity and a determination to improve himself and the world.”
In one exchange, Bhogal and Mangione “briefly touched on the differences between the UK and US healthcare systems," Bhogal said. “Luigi complained about how expensive healthcare in the US was, and expressed envy at the UK’s nationalized health system.”
Mangione also expressed concern about the sociocultural status quo in Japan, telling Bhogal that he was worried about the country’s declining birth rate and the number of young men “addicted to video games, pornography, and other shallow entertainments.”
Bhogal said he exchanged almost 20 emails with Mangione from April 6 to June 10. They also spoke via video chat for a total of two hours and traded direct messages on X and Substack.
When news broke that Mangione was a person of interest in Thompson's killing, Bhogal felt “bewilderment.”
“He was so thoughtful and polite that he seemed like the last person I’d suspect of murdering someone,” Bhogal said.
Ex-classmate says Mangione arrest 'does not track with what I thought he was as a person'
Marlene Lenthang
A former classmate described Mangione’s arrest as “shocking” and unlike him, recalling him a smart and socially well-adjusted student.
Mangione graduated in 2016 as valedictorian from the Gilman School, a private, all-boys high school in Baltimore.
“It’s just so shocking and does not really track with what I thought he was as a person,” Freddie Leatherbury, who was part of the same graduating class, told NBC affiliate WBAL of Baltimore. “I can tell you that this is one of the last people you think would do something like this. He was one of the nicest kids, most friendly kids that I had known at Gilman.
“There was nothing that came off weird about him. He had great friends. He had a lot of female friends as well,” Leatherbury continued. “He was down to earth. He was smart, well-adjusted socially. He was at least a two-sport athlete, from what I can remember, and he really had everything going for him.”
Mangione fights extradition, is denied bail at hearing
Carolina Gonzalez
Mangione was denied bail at his hearing at the Blair County Courthouse in Pennsylvania this morning.
He did not waive extradition to New York — meaning he will contest it — and he will remain in custody at State Correctional Institution-Huntingdon in central Pennsylvania.
Mangione’s legal team has two weeks to request a writ of habeas corpus order, which would prompt a hearing about whether his detainment is unlawful.
The district attorney said Mangione was found yesterday with driver’s licenses from New Jersey, New York and Maryland, as well as a laptop, a cellphone and additional masks.
Major health insurance stocks down since shooting
Mike Calia
Shares of UnitedHealth Group and other major health insurers are down since Thompson was killed last week.
According to a CNBC analysis, as of this afternoon, UnitedHealth, the parent company of UnitedHealthcare; Cigna; and CVS Health were all down more than 6% since their closing prices on Dec. 3, the day before a gunman killed Thompson on a Manhattan sidewalk. Humana, Centene and Elevance Health are also down since then.
The stock declines coincide with an increase in public vitriol directed at health insurers in the wake of Thompson’s death. Authorities said Luigi Mangione, who was arrested Monday and charged with murder, had a document on him in which he criticized the health care industry and wrote: “Frankly, these parasites had it coming.” Merchandise lauding Mangione has flooded e-commerce sites.
Still, even as shares of health insurers retreat, they remain valued at tens of billions of dollars. UnitedHealth is by far the biggest, with a share price of about $564 and a market capitalization of around $520 billion, despite losing more than $30 billion in value since the shooting. And the stock is way off its low for the year — $436.38 a share, which it hit in April.
CNBC’s John Melloy and Bertha Coombs contributed.
Mangione shouts as he arrives to courthouse
Marlene Lenthang
Mangione shouted and was disruptive as he arrived at the Blair County Courthouse this afternoon for his extradition hearing.
Handcuffed and dressed in orange prison garb, Mangione emerged from a sheriff’s car shouting and moving his shoulders as officers tried to hold him still and direct him to walk. At one point, he slammed into a wall as he tried to shout to the cameras.
Mangione looked back at reporters and started to yell: “It’s completely out of touch and an insult to the intelligence of the American people and their lived experience!”
He was quickly ushered into the building.
Altoona police received threats against officers and citizens in connection with Mangione arrest
Marlene Lenthang
Altoona Police Department Deputy Chief Derek Swopetold reporters this morning that there have been threats made against officers in the case of Luigi Mangione, calling it “a very polarized case.”
“We have received some threats against our officers and building here, we’ve started investigating some threats against some citizens in our community. We’re taking all those threats seriously and doing all the follow-up we can with those,” Swope said.
When asked if McDonald’s employees have been the target of threats, Swope punted and declined to reveal who the threats were against, but stressed that any threat against a citizen would be thoroughly investigated.
Swope said the police department hasn’t received any more tips about Mangione sightings in the area.
PA Department of Corrections releases Luigi Mangione's mug shot
Claudia Hernández

Mangione will have extradition proceeding today
Josh Cradduck
Marlene Lenthang
Josh Cradduck and Marlene Lenthang
Luigi Mangione is set to appear at the Blair County Courthouse at 1:30 p.m. ET today for an extradition proceeding, Pennsylvania court officials said.
That is the same courthouse where he was arraigned last night. Mangione faces murder charges in New York City.
'I wasn't working with anyone,' Mangione wrote in three pages of writings, officials say


Jonathan Dienst
Tom Winter
Jonathan Dienst and Tom Winter
Luigi Mangione, now arrested and charged with murder in the death of UnitedHealthcare CEO Brian Thompson had three pages of writings on him at the time he was taken into custody, officials said.
Those writings say — in part — “frankly these parasites had it coming,” three senior law enforcement officials said in describing the note to NBC News.
The NYPD said the writings are shorter than 300 words in total and include: “To the Feds, I’ll keep this short, because I do respect what you do for our country. To save you a lengthy investigation, I state plainly that I wasn’t working with anyone.”
However, while officials have said it appears Mangione acted alone, they have not ruled out any others who may have taken part.
Elsewhere, officials said, Mangione wrote, “I do apologize for any strife or traumas but it had to be done. Frankly, these parasites simply had it coming.”
The writings criticized the broader U.S. health care industry and large corporations, specifically including UnitedHealthcare.
There are concerns in the law enforcement community that these writings could cause others to act out in a similar capacity, those officials said.
Police bodycam images show Mangione sitting in McDonald's
Marlene Lenthang
Pennsylvania State Police shared photos depicting Luigi Mangione seated yesterday at a McDonald’s restaurant in Altoona, Pennsylvania.
The images show him wearing a dark hoodie, beanie hat and a mask. In one photo he appears to unmask to eat a hash brown.
Police released the photos asking for the public to share information on Mangione’s travel and recent whereabouts in the state. The images came from police body camera footage, which will not be publicly released at this time, an Altoona PD official told reporters today.

McDonald's customer recalls seeing Mangione
Debra Preitkis Jones
A man named Larry was at the Altoona, Pennsylvania, McDonald’s yesterday when one of his friends spotted Luigi Mangione and quipped: “That looks like the shooter from New York.”
Larry, who declined to share his last name, was enjoying coffee with his friends yesterday, a ritual for him and his pals at this McDonald’s. But yesterday’s regular get-together turned into the dramatic culmination of the search for the suspect in the killing of UnitedHealthcare CEO Brian Thompson.
Larry said one of his friends joked that the man looked like the person in the photos released by the NYPD after the Manhattan shooting, but they laughed it off. Later, Larry went to the restroom and saw Mangione sitting in the back.
“I thought it was one of the employees, because they go back here on break, and they put their hoods up, and he was in the corner with his hood up,” Larry recalled. He went to church and afterwards heard that police ended up going to that same McDonald's.
Larry said he went back to his friend Mike and asked what made him think Mangione was the shooter.
“He said, ‘I thought he had the same backpack, hood as the day I saw him in the pictures of the shooting.' He said he looked almost identical.”
“I think the one worker that actually thought it was him, she said, between his eyes and his eyebrows, she said, 'I took his order.' It was like she got in her mind. 'Oh, my God. It’s the guy from New York,'” he added.
Mangione is an 'activist killer,' former FBI counterintelligence assistant director says
Patrick Smith
Frank Figliuzzi, former assistant director for counterintelligence at the FBI, told NBC's "TODAY" show this morning that murder suspect Luigi Mangione looks to fit the profile of a ideologically-driven killer.
"Initially, Mangione did not seem to fit the profile of a cold-blooded killer. But as the picture starts to gel and come together, we are seeing what I would call an activist killer," he said.
"An ideology is driving his violence and we'll learn more about that as this goes on ... He's read the Unabomber's manifesto and aligned himself with the idea that it is sometimes ethical to murder someone," he continued.
Figliuzzi said that while a direct link between the suspect and UnitedHealthcare was still elusive, investigators would look at whether Mangione's actions are linked or inspired by his reported back problem.
NYPD commissioner calls Thompson's killing a 'tragedy'
Patrick Smith
Referring to some online posts that have expressed support for Luigi Mangione, the man accused of fatally shooting UnitedHealthcare CEO Brian Thompson, NYPD Commissioner Jessica Tisch said today that the killing was nothing short of a tragedy.
"I think the whole thing is an absolute tragedy. You have a father, a friend, a family man, who was killed and a young person who is a person of interest in a terrible homicide," she told NBC's "TODAY" show.
She added that the intense investigation into the killing goes on, including into the motive for the shooting.
"When we look at the manifesto, or three-page written document, you see anti-corporatist sentiment, a lot of issues with the health care industry. But as to issues with the specific motive, that'll come out as this investigation continues to unfold over the next weeks and months," she said.
Old-fashioned public appeal, not modern technology, caught murder suspect
Patrick Smith
Despite all the modern wizardry available to law enforcement these days, it was a simple, traditional image distributed to the media and the public that led to Luigi Mangione's arrest.
Police released an image from surveillance footage, showing a then-unidentified person of interest, on Dec. 5. Yesterday, a McDonald's employee recognized him and called the police.
Frank Figliuzzi, a former assistant director for counterintelligence at the FBI, told NBC's "TODAY" show this morning: "I'm a huge fan of crowdsourcing crime-solving. I remember way back in my FBI career we would agonize over the decision to share information with the public.
"Don't agonize anymore, get it out there — that's what broke this case, the video surveillance," he said.
"There's an interesting contrast with our high-tech forensics and sophisticated DNA, fingerprintings, scuba teams, and what solved this? Just putting out a photo of the guy," he added.
Catch up with NBC News' coverage of this story
NBC News
- Murder charge filed against UnitedHealthcare CEO suspect in New York
- What we know about Luigi Mangione, suspect in United Healthcare CEO’s shooting death
- ‘Extremely ironic’: Suspect in UnitedHealthcare CEO slaying played video game killer, friend recalls
Mangione wrote 'these parasites had it coming,' in handwritten note found by police

+2
Tom Winter
Jonathan Dienst
Patrick Smith
Tom Winter, Jonathan Dienst and Patrick Smith
Luigi Mangione, who was charged in the shooting of UnitedHealthcare CEO Brian Thompson last night, wrote "these parasites had it coming" in a handwritten note he left behind, a senior law enforcement official told NBC News.
That line comes from three pages of notes seized by police following his arrest in Pennsylvania yesterday morning.
The notes also referenced the health care industry, stated that he acted alone and contained the line, “I do apologize for any strife and trauma, but it had to be done,” the official said.
Officer only 6 months on the job says Mangione was ‘cooperative’ during arrest
NBC News
One of the officers who arrested Luigi Mangione has only been on the job for six months. Patrolman Tyler Frye and his partner recognized Mangione immediately as the man in photos distributed after Thompson was killed.