Luigi Mangione has pleaded not guilty to state murder and terror charges after allegedly shooting dead a health insurance CEO in New York.
Mr Mangione, appearing in Manhattan Criminal Court on Monday, faces life imprisonment without parole if convicted of killing Brian Thompson, the chief executive of United Healthcare, earlier in December 2024.
The 26-year-old entered the court under a heavy guard, wearing a red V-neck jumper over a white shirt for the brief hearing.
He pleaded not guilty to 11 state charges including first degree murder in furtherance of terrorism and two counts of second degree murder, one of which is charged as killing as an act of terrorism.
Federal prosecutors have brought a separate case against Mr Mangione which could see him face the death penalty if convicted of using a firearm to commit murder and interstate stalking resulting in death.
However, Joel Sideman, a prosecutor with the Manhattan district attorney’s office, said New York had “primary jurisdiction” over the case and would try it before the federal prosecution.
Mr Mangione will probably be returned to federal custody after the hearing, he added.
Throughout the proceedings, the defendant was reported to have sat stony faced next to his lawyer, Karen Friedman Agnifilo.
Around two dozen women queuing for the public seats said they were there to support the murder suspect and were visibly emotional when he walked in, according to ABC News. Several of them wore face masks.
“This is a grave injustice and that’s why people are here,” one of the women, who said she arrived at the courthouse at 5am, told the broadcaster.
Ms Friedman Agnifilo told the court that statements from city officials about Mr Mangione and his alleged crimes made her “very concerned about my client’s right to a fair trial”.
“This is a young man,” she said. “He is being treated like a human ping-pong ball between warring jurisdictions here.”
One official she named was Eric Adams, the New York mayor, who spoke briefly with Mr Mangione when he was extradited to the city last week. He later said he told him: “You carried out this terrorist act in my city, the city that the people of New York love.”
Judge Gregory Carro, said he was unable to control what happened outside court but vowed Mr Mangione would receive a fair trial.
Demonstrators outside the court – Michael Nagle/Bloomberg
Mr Mangione’s family, who live in Baltimore, did not appear to be present in the courtroom.
The death of Mr Thompson, who was shot repeatedly outside a hotel in Manhattan on Dec 4, has unleashed a wave of anger at health insurance companies, prompting some to close their offices as a security measure.
Last week, Ms Friedman Agnifilo suggested that the terror charges brought by New York conflicted with the claims of federal prosecutors.
The state charges accuse him of seeking to “intimidate or coerce a civilian population” – a precondition for a terror offence in New York – while the federal charges focus on crimes against an individual, she said.
When arrested, Mr Mangione was carrying a handwritten letter that called health insurance companies “parasitic” and complained about corporate greed, according to a law enforcement bulletin obtained by the Associated Press.
Investigators say ammunition found near Mr Thompson’s body was inscribed with the words “delay” “deny” and “depose”, mimicking a phrase used by critics of the health insurance industry.
The other charges against Mr Mangione include four counts of criminal possession of a weapon in the third degree, one count of criminal possession of a weapon in the fourth degree, and one count of criminal possession of a forged instrument in the second degree.