Behind UnitedHealth CEO’s accused killer, a possible history of back pain emerges

NEW YORK – A potential history of back pain emerged on Dec 10 as a point of interest in the UnitedHealthcare CEO murder case, based on accounts from two people who knew the suspect and details from his social media profiles.

Luigi Mangione is in custody in Pennsylvania and faces multiple charges there as well as murder charges in New York. While the gunman’s motive remains unclear, police have said Mr Brian Thompson, the head of one of the nation’s largest health insurers, was deliberately targeted.

The case has drawn intense interest online, where sleuths have looked for answers as to how a 26-year-old from a prominent family who had attended an Ivy League college ended up an accused murderer.

Social media commentators said clues about back pain could explain both personal distress and difficulties obtaining insurance coverage for treatment.

Reuters could not determine whether Mangione had been diagnosed with a back condition or whether he sought, or received, treatment including surgery.

On social media, Mangione left a trail of clues, including a picture of an X-ray of a spinal surgery on his X profile and a review on Goodreads of a book called Crooked: Outwitting The Back Pain Industry And Getting On The Road To Recovery.

In a 14-page handwritten document that Sky News identified as having been uploaded to his Google Drive account in 2021 and which has not been independently verified by Reuters, Mangione said he had a back injury known as an L5-S1 isthmic spondylolisthesis, in which one of the bones in the spine slips forward and presses on the vertebra below it.

Dr Wellington Hsu, professor of orthopaedic surgery at Northwestern University Feinberg School of Medicine, said about 6 per cent of the population has this condition and most people do not even know it because it typically does not cause pain.

About 20 per cent of people with this condition have symptoms, and of those, another 20 per cent may need surgery.

Mr Paul Piek, a 21-year-old software testing professional from Flensburg, Germany, met Mangione in March while watching a muay thai boxing fight in Ao Nang, Thailand.

The two and another friend of Mr Piek’s met up again in Krabi, Thailandm on April 8 and road tripped through Khao Sok and Bangkok, where they shared a hotel room for four nights and visited temples.

“He told us he did (muay thai) before his injury,” said Mr Piek.

He said Mangione told him he was interested in hiking when they met, with no further mention of his back injury.

“It didn’t seem like a problem”, though he did opt out of one guided hike for an easier walk, saying he was ill.

Mangione said he was “between jobs” while in Thailand, said Mr Piek, who described Mangione as a spontaneous travel companion, who enjoyed partying.

After travelling for another month alone, Mangione indicated in June that he was returning to the US, Mr Piek said. In July, Mr Piek stopped hearing from him.