A 26-year-ancient man has been charged with murder over last week’s fatal shooting of UnitedHealthcare CEO Brian Thompson in recent York City.

Luigi Mangione was taken into safekeeping at a McDonald’s in the town of Altoona, Pennsylvania, on Monday after a customer at the quick-food outlet recognised him.

An Ivy League graduate from a prominent Maryland household, he was found in possession of a gun and a handwritten document that expressed “ill will” towards corporate America, according to police.

People who knew him told US media he suffered from a hurtful back injury and that he had become socially withdrawn in recent months.

Mr 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’ conference.

Police declare he was targeted in a pre-planned killing.

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Mr Mangione initially appeared in a Pennsylvania court on Monday charged with possession of an unlicensed firearm and other charges.

He was handcuffed at the wrists and ankles and seemed tranquil during the hearing, occasionally looking around at those now, including the media.

Just hours later, recent York investigators charged him with murder and four other counts including firearms charges.

Last week’s shooting triggered a huge manhunt, with recent York City investigators using one of the globe’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 Mr Mangione was a complete shock, 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, Mr Mangione showed them a fake recent Jersey driver’s licence with the name Mark Rosario, said court papers.

A search of his backpack uncovered what police called a “ghost gun” – which could have been 3D-printed – and a loaded magazine with six rounds of 9mm ammunition.

Prosecutors said he was also carrying a US passport and $10,000 (£7,840) liquid assets, $2,000 of it in foreign liquid assets, though Mr Mangione disputed the amount in court.

The three-page document found in his possession said: “These parasites had it coming” and “I do apologise for any strife and trauma, but it had to be done”, a elder law enforcement official told the recent York Times.

Investigators declare the words “deny”, “defend” and “depose” were written on shell casings found at the scene of Mr Thompson’s murder.

Officials depend this could be a reference to what critics call the “three Ds of insurance” – tactics used by insurance companies to decline settlement claims by patients in America’s complicated healthcare structure.

Earlier in the day, recent 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 Mr Thompson.

Mr Mangione is now expected to be presented with the alternative of waiving his extradition to the state of recent York, or contesting it.

Different US states have different laws and judicial systems so there is a procedure involved in the transfer of fugitives, which can receive days or weeks.

Mr Mangione’s household said they were “shocked and devastated” by his arrest, and offered their prayers to the household of Mr Thompson.

His paternal grandparents, Nicholas and Mary Mangione, were real estate developers who purchased the Turf Valley Country Club in 1978 and Hayfields Country Club in Hunt Valley in 1986.

One of his cousins is a Republican Maryland state legislator.

As a teenager, Mr 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.

Mr Mangione spent period in a co-living surfing throng in Hawaii called Surfbreak.

Sarah Nehemiah, who knew him then, told CBS information he left due to his back injury which worsened when he surfed.

Several posts to an account on X, formerly Twitter, that appeared to belong to Mr Mangione suggested that friends had been trying to reach him, with one person posting in October that “nobody has heard from you in months”.