Mortal Wounds in D&D

I received the comment from one of my players that he in D&D would miss the worn and battered look of PCs after years of adventuring that is the natural outcome in a game like Warhammer Fantasy Roleplay. I agree with him, and I do think that the consequences of falling in battle in D&D can seem a bit trivial. Therefore I made a simple Mortal Wounds system, which is a merger between a regular critical hit table and the Lingering Injuries presented as an option in the Dungeon Masters Guide.

There are a couple of purposes:
– Having a consequence of dropping to 0 hit points for the individual (it is dangerous!)
– Giving characters marks of leading a rough and dangerous life
– Draining additional attention and resources during combat

I’ve already tested it in my 1st and 2nd level group playing Temple of Elemental Evil. During the first session, when I hadn’t introduced it yet, the Paladin dropped to 0 hit points three times (!). It is not that uncommon at low levels, so I introduced a Constitution save to mitigate the risk somewhat among the front-line types.
During the second session, the paladin dropped twice and the monk once. Both failed one saving throw, and the paladin lost 3 teeth and the monk bled badly. My conclusion is that from my limited experience it seems to be working. Both examples added drama and fun.

I have both a table for physical and energy attacks. The rule and physical table looks as follows:

Mortal Wounds:

Whenever a creature drops below 0 hit points, and thus receives a potentially mortal wound, there is a risk that the being will suffer some kind of permanent injury, or a more long lasting injury that requires special care or treatment. The player rolls a Constitution Save DC 8 + damage exceeding 0. If he fails the adventurer or creature rolls on the mortal wound table.

Physical Attacks:

Roll: 2d10 Effect:
2 The blow knocks you into a coma. You will not awake for 2d6 days unless a greater restoration is cast.
3 A rib is broken and causes internal bleeding. You receive disadvantage on stabilization rolls.
4 Your kidney is bruised, and you subsequently frequently piss blood, and have to go several times per night to piss.
5 You are hit on the head and receive a concussion. After stabilizing you will need 3 days of full rest. Until the rest has been completed you receive disadvantage on all saving throws, and cannot gain benefits from short rests.
6 A kneecap is hit, shattering it. The leg is useless until 10 points of magical healing is administered, and you are in incredible pain until it is done, screaming as loud as you can unless succeeding in a DC wisdom save.
7 The blow destroys a tendon in one of the legs, and you cannot walk without support until you have fully restored your hit points. You receive a limp on either left or right leg.
8 The blow damages either a non-magical weapon or shield held, armour worn or backpack. Roll randomly between them. You have to have the item repaired by a professional before it is usable again.
9 One of your limbs is broken (roll 1d4). Until at least 10 points of magical healing has been received the limb is useless.
10 A major vein is hit and you are bleeding heavily. Disadvantage on stabilization roll.
11 1d3 teeth are shattered or knocked out.
12 The hit will leave a large scar on a random body part 1: head 2: left arm, 3: right arm, 4: body, 5: left leg, 6: right leg
13 Your nose is broken and bleeds heavily. The nose has to be set or become misaligned.
14 The blow crushes or slices of a finger. Roll 1d8 to determine which digit.
15 The blow shatters the bones in one of your arms (roll random), damaging the nerves. Anything held is dropped, and you have disadvantage on any attack rolls using the hand, until restored to full hit points and having a restoration spell administered. You will retain a slight shake in the hand, which can only be removed by a regenerate.
16 You are hit heavily on the jaw dislocating it (which makes you unable to speak clearly) until magical healing has been administered.
17 One of your ears is mangled or sliced off by the blow. Roll randomly which. It can be restored if you receive at least 10 points of magical healing within 3 rounds.
18 Several bones in your face are crushed misaligning your face. You lose 1 point of Charisma, unless a cure spell is administered every day for the next three days to restore it. Regenerate or heal will also remove the damage.
19 One of your hands is destroyed. Unless magical healing is applied within 3 rounds, the hand is useless or severed.
20 An eye is destroyed. You receive -2 on ranged attacks. Regenerate can restore the eye.

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