As trial approaches, Mangione’s team has yet to unveil its full strategy. So far, his lawyers have not offered a robust alternative theory to the one prosecutors have put forth.

“We do not have, like in ‘The Fugitive,’ the idea of the one-armed man who’s the real killer,” said former federal prosecutor Mitchell Epner, referencing a 1993 thriller about a man wrongly convicted of killing his wife.

Earlier this summer, Mangione’s lawyers proposed, then quickly withdrew, an “extreme emotional disturbance” argument.

In such a defence, New York law requires lawyers to show a defendant “acted under the influence of extreme emotional disturbance for which there was a reasonable explanation or excuse”. Extreme emotional disturbance would allow the jury to consider the less severe charge of manslaughter, rather than second-degree murder. But jurors would have to be convinced of the accused’s state of mind at the time.

Some experts wondered if Mangione would argue a full insanity plea – different from emotional disturbance, but his lawyers have not proposed it.

“Short of being delusional, or having no understanding of the nature of what one is doing, an insanity defence is not likely to be successful,” said Cheryl Bader, who leads the Criminal Defence Clinic at the Fordham University School of Law.

Mangione’s team did not immediately respond to a request for comment.

As in every US criminal trial, the burden rests on the prosecution to prove its case to the jury beyond a reasonable doubt, a high legal bar.

“The more his case is about the question of who killed the victim, the easier it is for the prosecution,” said Epner.

Epner cited other themes, including healthcare in America, as potential narrative threads that could sway a jury in Mangione’s favour.

“The more it’s about the other peripheral issues, the harder it is for the prosecution,” he said.