Luigi Mangione indicted on federal charges in murder of UnitedHealthcare CEO: The health crisis that derailed the Ivy League alum's life

Luigi Mangione has been indicted in federal court on charges of murder, stalking, and a firearms offense. A federal grand jury in New York on Thursday returned a four-count indictment against the alleged UnitedHealthcare CEO killer that charges him with two counts of stalking, firearms offense, and murder through the use of a firearm, a charge that makes him eligible for the death penalty if convicted.

The 26-year-old, who was accused of fatally shooting UnitedHealthcare’s CEO on a Manhattan sidewalk last year, is facing both state and federal charges for the December 4 killing of Brian Thompson in a case that has exposed the public’s deep anger and frustration with the US health care system and insurance companies.

Federal prosecutors unsealed charges against Mangione late last year, but he had not yet been indicted on those charges until now. US Attorney General Pam Bondi has already signaled her intention to pursue the death penalty, which Mangione’s lawyers are actively trying to stop.

Mangione has previously pleaded not guilty to New York state charges of murder and terrorism.



However, before all this happened, before December 4, 2024, Luigi Mangione was an entirely different person. A young adult in the United States of America, claiming to be an Ivy League alumnus, with an impressive resume, has had quite a life – at least what we can derive from his social profiles. But all that, before a health crisis derailed the 26-year-old’s entire life.


Read on to find out what actually happened to Luigi Mangione.


Who is Luigi Mangione?

The 26-year-old took the internet by storm in December last year after the deadly shooting of UnitedHealthcare CEO Brian Thompson. Mangione was arrested in Pennsylvania while he was at a McDonald’s with his laptop and backpack.

Despite having an impressive LinkedIn profile, an interesting Tinder account, and a striking appearance, the Maryland-native ended up at the Metropolitan Detention Center (MDC) in Brooklyn, a federal jail in New York City, for the murder of the UnitedHealthcare CEO Brian Thompson, and now he might be facing a the death penalty if convicted.

However, before that berserk incident took place on December 4, 2024, as per his social media accounts, Luigi was suffering from a great deal of back pain.


What was he suffering from?

As per his social media accounts, Luigi was suffering from a back condition called spondylolisthesis, which can cause severe pain. Mangione had reportedly lived with chronic pain before undergoing spinal surgery in 2023, which may have contributed to his frustrations with the US healthcare system.

An image on his X banner appears to show an X-ray of his back after surgery, and several neurosurgeons and spine specialists agree that it looks like the operation was done to correct a condition known as spondylolisthesis .

A post from a Reddit account that appears to belong to Mangione, in a group dedicated to the condition, described having experienced pain and numbness in his back, limbs, and groin for a year and a half. A later post from the same account described the injury as “completely devastating.”


What is spondylolisthesis?

A spinal disorder in which a bone (vertebra) slips forward onto the bone below it.


Cause: Spondylolisthesis can be caused by degeneration, trauma, or congenital defects. It most commonly occurs in the lowest lumbar vertebra on the bony ring formed by the pedicle and lamina bones, which protect the spinal cord and spinal nerves.


Risk factors: Spondylolisthesis risk factors include sports that put stress on the bones in the lower back, such as gymnastics and football. Genetics may also put some people at increased risk. If the vertebra slips too far, it may press on nerves and cause severe back pain or nerve crowding that produces leg pain or numbness.


Treatment: If you have spondylolisthesis, nonsurgical treatments like rest, medication, and physical therapy should improve your symptoms. Your provider will take additional X-rays as you start treatment to see if your vertebra moves further out of alignment. Your provider will keep an eye on the out-of-place vertebra.



Difference between spondylosis and spondylolisthesis:

While spondylosis is a general term for degenerative changes in the spine, spondylolisthesis specifically refers to the displacement of vertebrae. Both conditions may coexist in some cases, and the appropriate management depends on the specific characteristics and impact on an individual's health.


What experts say:

Dr. Uzma Samadani, a Minnesota neurologist specializing in spine surgery, revealed that spondylolisthesis occurs when one or more vertebrae of the spine slip out of place. As per Samadani, because the vertebrae usually sit neatly on top of each other, when one slips out of place, it can compress both the disc that provides a cushion between the bones and the bundle of nerves that run through them, causing acute pain, chronic pain, or both.

According to the Cleveland Clinic, apondylolisthesis affects between 4% and 8% of the U.S. population, and the most common form, degenerative spondylolisthesis, can be due to the wear and tear of normal aging.

Although it’s far less common among young people like Mangione, when young people do develop spondylolisthesis, it often occurs after a back fracture due to athletic activities or traumatic accidents like a hard fall.

Having one of the 33 bones in his spine out of alignment by less than half an inch apparently diminished Luigi Mangione’s quality of life to the point that his lower legs felt like they were on fire. At other times, the 26-year-old charged with murdering the chief executive of UnitedHealthcare seesawed between pain and numbness in his lower back and genital area.

The severity of the condition also matters a great deal.

As the Cleveland Clinic suggests, if a vertebra has only slipped slightly out of place, the pain may be manageable without surgery. But a higher “grade” — or degree of slippage — case of spondylolisthesis can cause much more severe pain and warrant aggressive treatment.


R.J. Martin, a friend of Mangione’s who lived with him in Hawaii, told the New York Times that Mangione’s “lower vertebrae were almost like a half-inch off, and I think it pinched a nerve. Sometimes he’d be doing well and other times not.”

Mangione reportedly never mentioned being covered by or angry with United Healthcare specifically on any social media.


However, Samadani, who treats patients with spondylolisthesis, notes that many insurers require patients to undergo six to 12 weeks of physical therapy before the companies will agree to cover surgery or even imaging to diagnose the condition. As per her, for someone with severe spondylolisthesis, physical therapy can be “excruciating” and won’t necessarily help. She concludes, “It’s sort of like a torture, a mandatory torture imposed by the insurance company.”