The attack in a Nashville movie theater began when a man walked toward the back of the darkened room and brandished a hatchet, according to a 911 call released Thursday.
The caller described what the assailant, identified by police as 29-year-old Vincente David Montano, did Wednesday afternoon before he was shot and killed by police.
"This shady-looking guy stood up with, like, two bags and he walked toward the back of the theater and he pulled out, like, a hatchet and started attacking this family," said the caller. "Then he pulled out a gun and we all ran out of the theater."
The man said Montano was wearing "baggy ... dingy-looking clothes."
In addition to the hatchet, Montano was armed with pepper spray and a pellet gun "that closely resembled a semiautomatic pistol," and he was wearing a backpack on his chest and a surgical mask, according to the Metropolitan Nashville Police Department.
There were eight people in the theater, which was showing "Mad Max: Fury Road," when Montano began filling the room with pepper spray, police spokesman Don Aaron told CNN on Wednesday night.
One man was struck in the shoulder with the hatchet and suffered a "superficial wound," according to statements from Nashville police and fire officials. The man's wife and daughter were hit in the face with blasts of pepper spray, Nashville police said. Fire officials said all three victims were treated and released the same afternoon.
Montano was the only person still inside the theater when a Nashville police officer ran in to confront him, police said.
After a brief exchange of fire, the officer retreated, keeping Montano inside the room, police said. Police said they believe Montano then filled the theater with chemical spray.
A SWAT team entered shortly afterward, and Montano engaged them "for several minutes," using his pellet gun, according to police.
"As Montano's gun popped, sounding like a small-caliber pistol, four SWAT members fired," police said in a statement. "Montano ... ultimately attempted to flee out the rear door of the theater. As he emerged with ax in hand and started toward officers, five opened fire," killing him.
The attack took place at the Carmike Hickory 8 theater in the community of Antioch, south of Nashville International Airport.
No potential motive was revealed. Police said Montano had a history of mental health problems.
"This individual has had significant psychiatric or psychological issues," Aaron said late Wednesday, according to the Associated Press. "He had been committed four times, twice in 2004 and twice in 2007."
Court records show that in 2004, Montano faced charges of resisting arrest and assault on a police officer after an incident in Murfreesboro, about 30 miles outside Nashville. The records do not disclose the outcome of those proceedings.
Police said Wednesday that they believe Montano was homeless.
Police Chief Steve Anderson told reporters that the contents of Montano's backpack were designed to resemble a bomb but did not contain anything dangerous. A second backpack, which contained nothing harmful, was also recovered at the theater, Anderson said.
The attack in Nashville came less than two weeks after a 59-year-old drifter killed two people and injured nine in a barrage of gunfire inside a movie theater in Lafayette, La. That gunman killed himself as police closed in.
The incident also occurred in the shadow of the James E. Holmes trial in Colorado. Jurors there are in the process of determining whether Holmes, who carried out one of the worst mass shootings in U.S. history inside an Aurora, Colo., movie theater in 2012, should be put to death.