A 26-year-old man has been charged with murder over last week's fatal shooting of UnitedHealthcare CEO Brian Thompson in New York City. Luigi Mangione was taken into custody at a McDonald's in the town of Altoona, Pennsylvania, about 280 miles (450km) west of New York City on Monday after a customer at the fast-food outlet recognized him. An Ivy League graduate from a prominent Maryland family, he was found in possession of a 3D-printed gun and a handwritten document that indicated "motivation and mindset", according to police. Mangione then appeared in a Pennsylvania court to be arraigned on five initial counts and was denied bail. Just hours later, New York investigators charged Mangione with murder and four other counts including firearms charges. Thompson, 50, was fatally shot in the back last Wednesday morning outside the Hilton hotel in Midtown Manhattan where UnitedHealthcare, the medical insurance giant he led, was holding an investors' meeting. Police say he was targeted in a pre-planned killing. Mangione is in jail in Pennsylvania, where he was formally charged with possession of an unlicensed firearm, forgery and providing false identification to police. He was handcuffed at the wrists and ankles when he appeared in court there earlier on Monday. Wearing jeans and a dark blue jersey, Mangione seemed calm during the hearing, occasionally looking around at those present, including the media. Last week's shooting triggered a huge manhunt, with New York City investigators using one of the world's largest digital surveillance systems as well as police dogs, drones and divers in a Central Park lake to search for the attacker. Investigators revealed that finding Mangione was a complete surprise, as they did not have his name on a list of suspects before Monday. It was ultimately a McDonald's customer in Altoona that recognised the suspect from media coverage and alerted an employee, who then tipped off the police. When police arrived, Mangione showed them a fake New Jersey driver's licence with the name Mark Rosario, said court papers. He "became quiet and started to shake" when an officer asked if he had been to New York recently, the criminal complaint adds. When he was told he would be arrested if he lied about his name, he gave his real name, according to the court papers. Asked why he lied, he told officers that "I clearly shouldn't have". A search of his backpack uncovered a 3D-printed pistol, a 3D-printed silencer and a loaded magazine with six rounds of 9mm ammunition. Prosecutors said he was also carrying a US passport and $10,000 cash, $2,000 of it in foreign currency, though Mangione disputed the amount in court. A three-page handwritten document found on his possession suggested he harboured "ill will towards corporate America", said officials. Investigators say the words "deny", "defend" and "depose" were written on shell casings found at the scene of Thompson's murder. Officials believe this could be a reference to what critics call the "three Ds of insurance" - tactics used by insurance companies to reject payment claims by patients in America's complicated healthcare system. Earlier in the day, New York Police Commissioner Jessica Tisch said the weapon and suppressor seized by investigators from the suspect were "both consistent with the weapon used in the murder" of Thompson. Mangione is now expected to be presented with the option of waiving his extradition to the state of New York, or contesting it. If he waives it, he will immediately be made available to New York authorities. If he contests it, the process could take between 30 and 45 days. Mangione's family said they were "shocked and devastated" by his arrest. "We offer our prayers to the family of Brian Thompson and we ask people to pray for all involved," said their statement, which was posted on social media late on Monday by the defendant's cousin, Maryland state legislator Nino Mangione. As a teenager, Mangione attended a private all-boys school in Maryland, where he was class valedictorian, a title usually awarded to students with the best grades. He graduated from the University of Pennsylvania, an Ivy League college. His LinkedIn account says he worked as a data engineer in California. TrueCar, a website for car buyers, confirmed that he had been employed there but left in 2023. Mangione's last known address was in Honolulu, Hawaii. Several posts to an account on X, formerly Twitter, that appeared to belong to Mangione suggested that friends had been trying to reach him, with one person posting in October that "nobody has heard from you in months". — BBC