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An autopsy found that she died from a lethal dose of bupivacaine, a nerve-blocking drug that is rarely abused but often is used when an anesthetic is given.

Chemical analysis of the fluid from a saline bag used during his surgery revealed the presence of bupivacaine, the stimulant epinephrine and the topical anesthetic lidocaine, drugs that could have caused the patient’s sudden symptoms, according to prosecutors.

Dr. Ruth Landau, director of obstetric anesthesia at Columbia University Medical Center in New York, says maternity wards for months have faced a critical shortage of the fast-acting version of bupivacaine.

Anesthesiologists sometimes have had to use a slower-acting bupivacaine version, which may delay delivery and could harm mother or baby.

Hospitals also are grappling with shortages of regional anesthesia - local injections of lidocaine, bupivacaine and a third painkiller standard for eye surgery, orthopedic procedures and knee and hip replacements.