Michael R. Sisak (AP)
•6/17/2026
NEW YORK (AP) — Luigi Mangione will assert a psychiatric defense at his state murder trial in the killing of UnitedHealthcare CEO Brian Thompson, a judge said Wednesday.
Judge Gregory Carro said Mangione’s lawyers have informed him they will attempt to show that he was suffering from “extreme emotional disturbance at the time of the occurrence.”
If they succeed, Mangione could be sent to a psychiatric treatment facility instead of prison.
Carro’s ruling came two weeks after he held a secret hearing on the matter at the request of the defense. He said he will unseal records pertaining to the hearing and the defense’s move for a psychiatric defense.
The judge had been set to rule on the matter on Tuesday, but delayed it a day because prosecutors failed to inform Mangione’s jail that the defendant was needed in court.
Mangione sat between his lawyers wearing a blue suit and a light-colored button down shirt. He is set to go to trial on Sept. 8.
Mangione, 28, has pleaded not guilty to state and federal charges in the Dec. 4, 2024, killing. His federal trial, which involves stalking charges, is set to begin on Oct. 13. He could spend his life in prison if convicted in either case.
Thompson, 50, was killed as he walked to a Manhattan hotel for UnitedHealth Group’s annual investor conference. Surveillance video showed a masked gunman shooting him from behind. Police say “delay,” “deny” and “depose” were written on the ammunition, mimicking a phrase used to describe how insurers avoid paying claims.
Mangione, an Ivy League graduate from a wealthy Maryland family, was arrested five days later at a McDonald’s in Altoona, Pennsylvania, about 230 miles (about 370 kilometers) west of Manhattan. At the May 18 hearing, Carro ruled that a gun and notebook that prosecutors say link Mangione to the killing can be used as evidence against him.
The gun, a 3D-printed pistol, matches the one used to kill Thompson, prosecutors said. The notebook describes wanting to “wack” a health insurance executive and rebelling against “the deadly, greed fueled health insurance cartel.”
Also Wednesday, Carro dismissed a charge related to a gun magazine that he had ruled inadmissible because it was found during an initial search of Mangione’s backpack at the McDonald’s.
