FAYETTE COUNTY, Ohio — Luigi Mangione, the 27-year-old Maryland man accused of gunning down UnitedHealthcare CEO Brian Thompson in a brazen Manhattan ambush, meticulously plotted a bus route through the quiet farmlands of Fayette County, Ohio, as part of his effort to vanish into the American heartland, prosecutors revealed Tuesday during a pretrial hearing.
Handwritten notes and a crude, hand-drawn map — seized from Mangione’s backpack upon his arrest — detailed a low-profile itinerary designed to exploit overnight travel, evade surveillance cameras and throw off pursuing FBI agents. The documents, which Mangione’s lawyers are fighting to suppress, paint a picture of a fugitive prioritizing stealth over speed, with Fayette County’s sparse population and rural stretches of Interstate 71 as a key waypoint in his southward flight.
Mangione faces state and federal charges, including first-degree murder and stalking resulting in death, for the Dec. 4, 2024, shooting of Thompson, 50, outside the New York Hilton Midtown. Thompson, a father of two who led the nation’s largest health insurer, was shot twice in the back and once in the leg as he walked to his company’s investor conference. Surveillance footage captured the masked gunman — later identified as Mangione — firing from behind before fleeing on foot, leaving behind shell casings etched with the words “delay,” “deny” and “depose,” a pointed reference to insurance industry tactics for rejecting claims.
Prosecutors allege Mangione, a former data engineer from a prominent Baltimore family, was driven by deep-seated resentment toward the U.S. health care system, which he described in a notebook as “parasitic” and emblematic of corporate greed. A University of Pennsylvania graduate who had been living in San Francisco before going missing in July 2024, Mangione checked into a Manhattan hostel under a fake name days before the killing. His family, including cousin Maryland Delegate Nino Mangione, expressed shock at his arrest, offering prayers for Thompson’s relatives.
The shooting ignited national outrage and online fervor, with social media erupting in criticism of UnitedHealth Group and even a “Free Luigi” billboard in California. A University of Chicago poll later found most Americans blamed insurers’ claim denials for contributing to the violence.
But as Mangione allegedly melted into the shadows of New York that morning, his focus shifted to escape. According to notes shown in court, he took a train from Newark, New Jersey, to Philadelphia, boarding a Greyhound bus under the alias “Sam Dawson” that evening for the nearly six-hour ride to Pittsburgh, arriving just before midnight. From there, the plan called for catching a “red eye” — an overnight bus — south to Columbus, Ohio, with an early exit to minimize exposure.
“Check Pittsburgh → red eyes (get off early),” one note instructed in Mangione’s alleged scrawled handwriting, followed by “to Columbus or Cincinnati.” The accompanying map, a hasty sketch linking Pittsburgh, Columbus, Cincinnati, Indianapolis, St. Louis, Detroit and Louisville, Kentucky, circled Cincinnati as a hideout spot. Prosecutors say Mangione intended to disembark there, lay low briefly to “conceal and throw off cameras,” then board another bus to Lexington, Kentucky — a zigzag path avoiding major airports and direct highways.
The route’s linchpin: a 50-mile dash down I-71 through Fayette County, a rural enclave of about 28,000 residents southeast of Columbus. Home to rolling cornfields, small towns like Washington Court House and the historic village of Jeffersonville, the county offered Mangione what his notes described as ideal cover: low traffic, few cameras and a sleepy overnight vibe. “Keep momentum, FBI slower overnight,” he wrote, betting on federal investigators’ lag time in the wee hours. The plan also included mundane evasion tactics: “Change hat, shoes, pluck eyebrows” for disguise, plus stops for “trash bag(s)” to ditch evidence and a “survival kit” with water and snacks.
Fayette County, with its brick-lined under streets in Washington Court House and annual fair drawing locals to livestock shows and tractor pulls, is far removed from the skyscrapers of Manhattan. County Sheriff Vernon Stanforth, reached by phone Tuesday, said his office was captivated by the news as everyone else when the shooting happened, unaware Mangione would cross into the Sheriff’s jurisdiction during the manhunt.
Prosecutors say the notes, found crumpled in Mangione’s pocket alongside a fake New Jersey ID and a SEPTA transit pass timestamped 1:06 p.m. on the day of the shooting, prove his “camera-savvy” flight. The backpack search at an Altoona, Pennsylvania, McDonald’s — where Mangione was nabbed Dec. 9 after a tip from a customer — also yielded a 3D-printed 9mm Glock with suppressor, loaded magazines, a passport and a red notebook outlining his alleged motive.
The current phase of Mangione’s suppression hearing, now in its sixth day in Manhattan Supreme Court, hinges on whether Altoona officers needed a warrant to rifle through the backpack. Body camera footage played in court shows officers debating the issue amid Christmas carols, with one pulling out a hoagie sandwich and wet underwear concealing bullets before unearthing the gun. Defense attorney Karen Friedman Agnifilo argues the search violated New York law and Miranda rights, calling the items “fruit of the poisonous tree.” Prosecutor Joel Seidemann counters that officers feared a bomb and later secured a warrant, dubbing the backpack contents a “manifesto” of premeditation.
Mangione, clean-shaven in a gray suit, sat stone-faced as the map was projected, occasionally whispering to Agnifilo. He has pleaded not guilty and remains held without bail.
If admitted, the notes could show how Mangione — top of his class at Baltimore’s Gilman School and an Ivy League scholar — methodically gamed public transit to slip through overlooked corridors like Fayette County. Judge Melissa Crane is expected to rule on the evidence soon, with trial set for early 2026.
Thompson’s killing, the first assassination of a Fortune 500 CEO in decades, continues to fuel debates on health care inequities. UnitedHealth, facing lawsuits over claim denials, has not commented on Mangione’s plans. For now, the scribbled path through Ohio’s breadbasket stands as a stark reminder: In America’s vast interior, a bus ticket and a plan can buy a fugitive precious hours.