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The issue of mental incompetency can be lengthy. It followed the Elizabeth Smart kidnapping case for nearly nine years. Brian David Mitchell was arrested several months after the 2002 abduction of the Utah girl — who was raped and tortured over a nine-month period — but was only sentenced Wednesday to two life terms. The case stalled during the interim after he was deemed incompetent for trial in state court. He was ruled competent, however, in the federal court system and convicted last year.

Loughner has pleaded not guilty to 49 federal charges stemming from the shooting, which wounded Giffords and 12 others and killed six people, including a 9-year-old girl and a federal judge.

Loughner was calm at the beginning of Wednesday’s hearing, tilting his head and swaying back and forth. Later, he began to speak and interrupted the proceedings.

His words were loud but difficult to make out. He said what sounded like: “Thank you for the freak show. She died in front of me.” Some reporters also heard him say what sounded like “You’re treasonous.”

The AP has asked the court clerk’s office for an official transcript and recording of the hearing.

Following the outburst, two marshals standing behind Loughner’s chair grabbed him by each arm and led him from the courtroom. Loughner’s father, sitting a few rows behind him, lowered his eyes and huddled with two women.

Shortly after Loughner was led away, the judge told the attorneys the suspect was entitled to be in the courtroom as long as he composed himself. “I don’t want him to act up or speak out,” Burns said.

After a 10-minute recess, the marshals said Loughner had calmed down. They then brought him back into the courtroom, and the judge asked Loughner if he wanted to stay and behave, or view the hearing on a TV screen in another room.

“I want to watch the TV screen,” Loughner said, the two marshals tightly gripping his arms.

In addition to Fuller, the survivors included Giffords aide Pam Simon, who was shot in the chest and right wrist, and retired Army Col. Bill Badger, who is credited with helping subdue Loughner after a bullet grazed the back of Badger’s head.

Outside the grocery store where the shooting occurred, Diane Mencarini, who isn’t involved in the case, said she was disturbed that the case against Loughner is on hold while therapists work to improve his mental condition.

“That sort of lets him off the hook, for a while at least,” Mencarini said.

Prosecutors had requested the mental exam, citing a YouTube video in which they believe a hooded Loughner wore garbage bags and burned an American flag.

The judge gave the two experts access to Loughner’s health records from his pediatrician, a behavioral health hospital that treated him for extreme intoxication in May 2006 and an urgent care center where he was treated in 2004 for unknown reasons.

Prosecutor Wallace Kleindienst said that Loughner will be sent to the Missouri facility in the next few days.

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