Mr Loughner, 22, was found by Judge Larry Burns to be “mentally incompetent” to take part in a trial and assist with his own defence, during a hearing Tucson on Wednesday.
At one point he was dragged out of the courtroom by US marshalls, after an outburst in which he shouted: “She died in front of me” and “Thank you for the freak show”.
He is charged with 49 counts relating to the shooting spree at a meet-the-voters event hosted by Miss Giffords in a supermarket carpark on January 8.
The Democratic congresswoman, 40, was shot through the head but is recovering in a rehabilitation centre. Six people, including a 9-year-old girl and a federal judge, were killed and 12 others injured.
Mr Loughner, who is described by his lawyers as a “gravely mentally ill man”, denies all the charges. He could face the death penalty if he stands trial and is convicted.
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