On December 4, 2024, Brian Robert Thompson, the CEO of the American health insurance company UnitedHealthcare, was shot and killed by 26-year-old Luigi Mangione outside the New York Hilton Midtown in Manhattan, New York City, where Thompson was heading to attend an investors' meeting.
The perpetrator, initially described as a white man wearing a mask, fled the scene. The words "delay", "deny", and "depose" were inscribed on the cartridge cases used during the shooting. On December 9, 2024, authorities arrested Mangione in Altoona, Pennsylvania, and charged him in a Manhattan court with multiple charges including Thompson's killing. Authorities alleged that when Mangione was apprehended, he was carrying a 3D-printed pistol and a 3D-printed suppressor consistent with those used in the attack; a short handwritten letter criticizing the American healthcare system; an American passport; and multiple fraudulent IDs, including one with the same name used to check into a hostel on the Upper West Side of Manhattan.
Mangione was indicted on eleven state charges and four federal charges; the charges include first-degree murder, murder in furtherance of terrorism, criminal possession of a weapon, and stalking. His terrorism-related murder charges in the New York state's case were dismissed in September 2025. A judge dismissed two federal charges in January 2026, ruling that prosecutors could not seek the death penalty against Mangione. On August 14, 2026, Mangione pleaded guilty to the federal stalking charges and admitted to shooting Thompson, stating that he was motivated to shoot the CEO "after years of enduring severe pain from a broken back, navigating the obstacles of the health insurance system and witnessing similar experiences of countless others".
Thompson's death received widespread attention in the United States and led to polarized reactions. Several public officials expressed dismay and offered condolences to Thompson's family, while many used the event to call attention to the practices of the US health insurance industry. Opinion polls have shown that a majority of American adult respondents find the killing unacceptable, but with a plurality of younger respondents viewing the killing as acceptable, and a majority of Americans believing that denials of health care coverage and profits made by health insurance companies contributed to the UnitedHealthcare CEO's death. On social media, reactions to the killing included widespread contempt and mockery toward Thompson and UnitedHealth Group, sympathy and praise for Mangione, and broader criticism of the American healthcare system and health insurance industry—primarily regarding claim denial practices.
Background
Thompson and UnitedHealthcare
Brian Robert Thompson (July 10, 1974 – December 4, 2024) was the chief executive officer (CEO) of UnitedHealthcare, the insurance arm of UnitedHealth Group, from April 2021 until his death. He had worked for UnitedHealthcare since 2004. UnitedHealthcare insures 49 million Americans and generated $281 billion in revenue for the 2023 fiscal year. At the time of Thompson's death, the company was the largest health insurer in the United States.
UnitedHealthcare had repeatedly faced criticism for its approach to handling claims. It and other insurers were named in an October 2024 report from the United States Senate Homeland Security Permanent Subcommittee on Investigations showing a surge in prior authorization denials for Medicare Advantage patients. Reports of increasing rates of prior authorization denials prompted investigations by ProPublica and the United States Senate, investigations which were described as a "stain" on Thompson's time of leadership by Fortune. According to Thompson's widow, he had been receiving threats related to a "lack of [insurance] coverage". In May 2024, a lawsuit was filed against Thompson along with Stephen Hemsley and two other senior executives for alleged fraud and alleged insider trading due to failing to disclose an antitrust investigation into the company by the United States Department of Justice and by selling stock options before the probe was made public.
Mangione's preparations
The suspect arrived in New York City on November 24, 2024, on a Greyhound bus. The bus route began in Atlanta, Georgia, but authorities do not know from which city or town he boarded. The day of his arrival, he checked into the HI New York City Hostel on the Upper West Side of Manhattan with a falsified New Jersey identification card; he paid for his stay in cash. He stayed at the hostel for all but one night of the 10 days he was in New York City, checking out on December 3.
After his guilty plea, Mangione revealed that he had contacted UnitedHealthcare to gain access to details of the event Thompson was heading to by posing as an investor from a multibillion dollar firm.
Killing
Thompson was in New York City for an annual UnitedHealth Group investors' meeting, having arrived from Minneapolis on December 2, 2024. On December 4, at around 6:45 a.m. EST (UTC−5), Thompson was walking along West 54th Street toward the New York Hilton Midtown hotel that was hosting the meeting. Mangione waited across the street from the hotel for several minutes, then crossed over when he saw Thompson. Standing approximately 20 feet (6 m) away from Thompson when he arrived at the entrance, Mangione fired three times at him from a suppressed 9 mm pistol, striking him in the back and right calf. Three spent bullet casings were found at the scene, along with three ejected live rounds.
In the closed-circuit television camera (CCTV) recording of the killing, Mangione manually cycles the gun action after each shot, leading observers to believe that his weapon was a malfunctioning semi-automatic pistol. The authorities believe it to be the weapon they found in Mangione's bag after his arrest—a partially 3D-printed Glock 19 and 3D-printed suppressor. The ghost gun consists of a 3D-printed lower receiver, metal slide, unserialized Glock 19 internals from a parts kit, including a threaded barrel, and uses a standard Glock magazine. The 3D-printed part's design was an iteration of "FMDA 19.2", a design released in 2021 by the libertarian group Deterrence Dispensed.
Mangione fled the scene on an e-bike to Central Park; there, near the Carousel, he shed a backpack containing Monopoly money, candy, and a jacket before exiting the west end of the park at 77th Street. According to the police, he then left the city from the George Washington Bridge Bus Station farther uptown in Upper Manhattan. Thompson was taken to Mount Sinai West hospital, where he was pronounced dead at 7:12 a.m. According to a later autopsy report, Thompson died from a gunshot wound to the back of the torso.
Timeline
- November 24, 10:11 p.m. – Mangione arrives at the Port Authority Bus Terminal in Midtown Manhattan on a Greyhound bus which originated in Atlanta, Georgia, and makes up to seven stops en route.
- November 24 – Mangione checks into the HI New York City Hostel on the Upper West Side of Manhattan. His unmasked face was caught on CCTV during the check-in process. Mangione had two hostel roommates who said he would slip down his mask only when eating.
- November 24 – Mangione cases the New York Hilton Midtown hotel.
- November 29 – Mangione checks out of the HI New York City Hostel.
- November 30 – Mangione checks back into the HI New York City Hostel.
- December 4:
- 5:34 a.m. – Mangione leaves the hostel, and rides an e-bike to Midtown.
- 6:15 a.m. – Mangione is seen leaving the 57th Street F Train subway stop.
- 6:17 a.m. – Mangione buys coffee, water, and granola bars at a Starbucks café (at 1380 6th Ave) two blocks away from the New York Hilton Midtown hotel, discarding the coffee cup and water bottle.
- 6:30 a.m. – Surveillance footage captures Mangione walking while talking on the phone.
- 6:39 a.m. – Mangione arrives in front of the New York Hilton Midtown hotel and waits for several minutes.
- 6:40 a.m. – Thompson leaves the Marriott hotel (at 151 W 54th St) he stayed at the prior night, heading toward the New York Hilton Midtown hotel.
- 6:44 a.m. – Thompson walks along the sidewalk toward the New York Hilton Midtown hotel and Mangione shoots him multiple times, racking his pistol after it appeared to jam; the suspect immediately flees northbound via a pedestrian walkway.
- 6:46 a.m. – Police respond to a 911 call reporting that a person has been shot.
- 6:48 a.m. – Officers arrive on scene and find Thompson with multiple gunshot wounds to his back and leg; he is taken to the hospital.Mangione is seen riding an electric bicycle north into Central Park.
- 6:59 a.m. – A person believed to be Mangione is seen riding a bike on West 85th St.
- 7:04 a.m. – Mangione gets into a northbound taxi on 86th Street and Amsterdam Avenue.
- 7:12 a.m. – Thompson is declared dead at Mt. Sinai Hospital.
- 7:30 a.m. – Mangione arrives at George Washington Bridge Bus Station.
Investigation
Three fired cartridge cases alongside three unfired cartridges were found at the scene. The words "delay", "deny", and "depose" were written on the cases. "Depose" was inscribed on a casing from a round fired into Thompson, while "delay" was marked on an unfired cartridge ejected as the shooter appeared to be clearing a jam. The three words are similar to the phrase "Delay, Deny, Defend", a phrase adopted by critics of the American healthcare industry alluding to health insurance companies' efforts to not pay out claims. Accordingly, police stated they were investigating whether the words suggest the killer's motive.
A water bottle, candy wrapper, and phone were recovered from the scene and are believed to be connected to the shooter. Police said they believed they found the shooter's backpack in Central Park on December 6, 2024. The backpack contained a Tommy Hilfiger jacket and Monopoly money.
The New York City Police Department offered a reward up to $10,000 for information about the shooter on December 4, 2024. The following day, authorities released images of a suspect taken by surveillance cameras at the hostel and a Starbucks café. Two stills show the suspect's face, including one with him smiling widely at a female desk attendant at the hostel. Sources told CBS the front desk worker asked to "see his pretty smile." The FBI joined the investigation and separately offered a reward of up to $50,000 for information leading to an arrest and conviction.
The shooter was described by police as a white man, approximately 6 ft 1 in (185 cm) tall, wearing a light brown or cream-colored hooded jacket, dark pants, and black sneakers with white soles. He had a gray backpack and concealed his face with a black face mask. Police said the suspect appeared to be proficient in the use of firearms and was described as being "extremely camera savvy".
Perpetrator
Luigi Nicholas Mangione was born in Towson, Maryland on May 6, 1998. He graduated from the University of Pennsylvania. Prior to his arrest, Mangione had no criminal record. His last known residence was in Honolulu, Hawaii. In November 2024, Mangione was reported missing by his mother, who said the family had not heard from him since July of that year.
Arrest and charges
Local police in Altoona, Pennsylvania, arrested Mangione on December 9, 2024, at a McDonald's restaurant on East Plank Road in the city. An employee there called the police to say that a customer recognized the suspect from images released by the NYPD. Altoona is about 280 miles (450 km) west of New York City. In his bag they found a 3D-printed gun and a 3D-printed suppressor, which the police said are consistent with the weapon used in the shooting, and a falsified New Jersey driver's license with the same name as the one used by the shooter to check into the Manhattan hostel. Authorities also said his fingerprints matched the partial smudged prints that investigators found near the New York shooting scene. The police also said that when they arrested Mangione, they found a three-page, 262-word handwritten document about the American healthcare system, which they characterized as a manifesto.
Mangione was charged in Blair County, Pennsylvania, with carrying a gun without a license, forgery, falsely identifying himself to the authorities, and possessing "instruments of crime" on December 9, 2024. He was arraigned at around 6 p.m. at Blair County Courthouse, pleaded not guilty to all the charges, and was denied bail. By the end of the day, he was charged in Manhattan with second-degree murder, three counts of illegal weapons possession, and forgery. He was held in the State Correctional Institution at Huntingdon, a close-security state correctional facility in Huntingdon County, Pennsylvania.
Mangione hired Karen Friedman Agnifilo, former prosecutor at the Manhattan District Attorney's Office and former legal analyst with CNN, as his New York case defense attorney. On December 17, New York prosecutors charged him with first-degree murder as murder committed in furtherance of terrorism. This charge and indictment modified the murder charge with which he was already charged, as the charge of murder as an act of terrorism holds more weight than just a simple murder charge. He was extradited to New York on December 19 and transferred to the Metropolitan Detention Center, Brooklyn, following his first appearance in the Manhattan federal court. On December 23, Mangione pleaded not guilty to all New York state charges. In addition to the eleven state charges, he faces four new federal charges, including two counts of stalking, a new firearms-related offense, and murder through use of a modified firearm. On April 1, U.S. Attorney General Pam Bondi directed prosecutors to seek the death penalty in the federal case. The state charges carry a maximum sentence of life imprisonment.
On August 14, 2026, Mangione pleaded guilty to the two federal stalking charges, and admitted that he killed Thompson.
Handwritten letter
Upon Mangione's arrest, police said they found in his possession a 262-word handwritten document, which many media outlets characterized as a "manifesto". According to NYPD commissioner Jessica Tisch, the handwritten document spoke to Mangione's "motivation and mindset". Journalist Ken Klippenstein published a transcription of the document found on Mangione; according to Newsweek, police confirmed that the transcription was legitimate. The document reads as follows: