Luigi Mangione pleads guilty to fatal shooting of UnitedHealthcare CEO Brian Thompson

After more than a year-and-a-half of intense spectacle and legal wrangling, Luigi Mangione appeared in a federal courtroom in New York on Friday as rumours swirled that he may plead guilty.

The 28-year-old, accused of fatally shooting UnitedHealthcare chief executive Brian Thompson on a Manhattan street in December 2024, arrived wearing a beige prison uniform with a white T-shirt underneath.

His feet were shackled and he held his hands behind his back, although US marshals had not handcuffed him.

A crowd of reporters, supporters of Mangione, observers and a handful of court staff who had won a lottery to attend gathered in the packed courtroom.

And in the front row seated behind the prosecution: Thompson's family members, who at times appeared visibly emotional.

As the packed room awaited the arrival of Judge Margaret Garnett, Mangione conferred with his lawyer Karen Friedman Agnifilo, reviewing papers as we waited to hear whether Mangione would admit to the killing for the first time.

The hearing had been scheduled to begin at 11:00, but started slightly later.

It began with an immediate jolt.

Friedman Agnifilo told the judge: "Mr Mangione is prepared to plead guilty at this time."

From then on it was silent, as the judge asked Mangione a series of questions to ensure he understood the decision he was about to make. She asked him about his background and use of medications. He answered the questions tersely but firmly.

Asked if he understood that he could face life in prison - he replied "yes".

Only when he began to read a statement to the court, did Mangione appear to falter. His speech was rushed and somewhat mumbled.

After Judge Garnett politely suggested he lean into the microphone, he continued steadily until he reached his conclusion: an admission that he had killed Thompson.

There had been reports in US media leading up to the hearing that Mangione would be taking a plea deal. That is not what happened - Mangione simply changed his plea of not guilty to guilty.

"After years of enduring severe pains from a broken back" and dealing with the healthcare insurance industry, Mangione stated that he had learned UnitedHealthcare would hold an annual conference in Manhattan in December 2024.

He researched online and emailed the company posing as an investor to learn more about the event, Mangione told the court. "Unlike previous interactions with insurance" he got a quick reply, he said.

He told the court he used a 3D printer to make a gun.

And on the morning of 4 December 2024, Mangione confessed: "I shot Mr Thompson in Manhattan and he died."