Death and Dismemberment and Dice

Version whatever, based on Crittable.

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When dropped to 0 HP, compare any excess damage to the list below. Don't track negative HP, just compare to the damage taken. Death Dice (DD) add 1d6 damage to every blow taken while at 0 HP.

Each long rest clears all of your DD and heals a random Minor Injury. If you want to try and patch (not heal) a Minor Injury, anyone can make an Intelligence check, but only once per injury. Advantage to the check over lunch. If they succeed, you can use that limb (or whatever) but it is still injured.

If you already have an Injury and gain it a second time, or an effect is impossible to apply, move to a greater severity: Minor Injury > MAJOR INJURY > Save or Die.

Optional: If you are dropped to exactly 0 HP from maximum HP, gain a Scar.

The Result:

1. Too close for comfort. +1 Death Dice
2. Cut, bruised or marked, +1 DD
3. Drop held item or +1 DD (if no held item, lose random from inventory)
4. Slashing: Knocked prone, Piercing: +2 DD Bludgeoning: Stunned, 1 round, Fire/Acid: Shaken, 1 round Other: +1 Trauma or +1 DD
5. Horrifying near-miss, +1 Trauma
6. Painful injury, +1 DD and Shaken for 1d4 rounds (disadvantage on all checks bar Defence)
7. Stunned for 1 round, +2 DD
8. Choose +2 DD or take a Minor Injury
9. Permanent reminder of the blow, +1 DD, +1 Trauma
10. Take a Minor Injury (left arm/even), +2 DD
11. Take a Minor Injury (left leg/odd), +2 DD
12. Take a Minor Injury (right arm/even), +3 DD
13. Take a Minor Injury (right leg/odd), +3 DD
14. Knocked prone, disarmed and in a bad position, +2 DD
15. Minor Injury, whichever would be worse, +3 DD
16. Random stat takes damage equal to current DD (not permanent), +3 DD
17. Unconscious for 1d4 rounds, +3 DD
18. +1d6 Trauma, +2 DD, if you contract an Insanity it's probably going to be a phobia of whatever just hit you
19. +2 DD, make a Wisdom check or Shaken until combat ends 
20. Major Injury (arm/even), +5 DD
21. Major Injury (leg/odd), +5 DD
22. +6 DD, automatically suffer a Breakdown
23. SLOW DEATH. Paralysed, broken, doomed etc. could take hours or even days
24. JUICY DEATH. Blood everywhere, a slipping hazard, might be able to halt the gushing...
25. DISEMBOWELLED, DIE STARING AT YOUR INTESTINES IN 1d8 ROUNDS
26. DROWN IN YOUR OWN BLOOD OVER 1d6 ROUNDS
27. SHOCK, DIE SUDDENLY IN 1d4 ROUNDS
28. LIMBS SCATTERED
29. SKULL SHATTERED
30. TORN ASUNDER
31. HORRENDOUS FATE, TRAUMATISE YOUR ALLIES FOR 1d6 ROUNDS THEN DIE
32. ABSURD DEATH, HOW DID THAT EVEN HAPPEN?
33. DECAPITATION
34. or more - TOTAL OBLITERATION

Injury List (Either use the given injury or Slashing, whichever makes more sense. If you need to pick between the Odd and Even result, look at the most recent damage roll / d20):

Type/Damage	Minor	MAJOR
Slashing/Default	Odd - Leg, Even - Arm, cannot use that limb. If the most recent d20 you rolled was even, it's the right side of the body	CHOPPED, if you succeed on a save, lose a finger/toe. If you fail, the whole limb is smashed to pieces, sliced off, pulped etc
Bludgeoning	Odd - Concussed, treat Initiative as 4, spells have a 1-in-6 chance to fail Even - Winded, stunned and prone until you make a CON/2 check. An ally can spend a full round helping you up, ending the condition	CRUSHED, If you succeed on a save, you gain a cool scar. If you fail, roll 1d6: 1. Lose 1 Strength 2. Lose 1 Wisdom 3. Lose 1 Intelligence 4. Crushed throat. You cannot speak louder than a whisper 5. Crushed ribs. Treat Con as 4 when holding your breath 6. Your back goes crunch and you are paralysed from the neck down. Make Con saves at 2d6 rounds or 1d6 days to recover, if you fail both its permanent
Piercing	Odd - Jabbed, lose 1d6 max HP Even - Shanked, attacker chooses which arm is disabled	SPLIT, if you succeed on a save, you gain a cool scar. If you fail, roll 1d6: 1. Lose 1 Constitution 2. Lose 1 Dexterity 3. Lose 1 Charisma 4. Lose an eye, -1 Ranged Attack 5. Oozing wound, contract disease 6. Eviscerated. In 1d6 rounds, save or die, then again 1d6 rounds after that
Fire/Acid	Odd - Sizzling, take 1d6 ongoing damage as normal, remember that if you are already suffering the effects, move to the MAJOR INJURY Even - Scorch, lose a random item	IT BURNS, take 1d12 damage ongoing instead of 1d6
Poison/Necrotic	CON check vs. vomiting (stun) for 1d6 rounds, no benefit from Lunch	ORGAN FAILURE, 1d4 CON damage each round, save ends
Cold	Frostbite, treat Dexterity as 4 due to shaking, Save or lose a random extremity (finger, toe, ear etc.)	CHILL OUT, save or end up a solid block of ice. Hard impacts may require you to save vs. shattering
Lightning/Radiant	Stunned for 2d6 rounds	HEART ATTACK, save or die. If you take lightning damage again in the next 1d6 minutes, make a Constitution check to revive
Psychic	Take Trauma equal to damage, suffer the MAJOR INJURY if you are already having a breakdown	Odd - ENSLAVED, take a single command from the attacker, Save or Die if you resist Even - ALL IN YOUR HEAD, you are now (1d4): 1. Blind, 2. Lame, 3. Mute, 4. Prone to seizures
Magic	Roll a random mutation, no benefits	DOOMED, roll a random curse

Random Disease:

1. Grave Lung, 1d4 Strength, Constitution check or cough when sneaking
2. Spasms of the Liver, 1d2 Constitution, halve all healing
3. Stoneskin, 1d6 Dexterity, +1 Defence if you’ve taken 5+ total
4. Leprosy, 1d3 Dexterity, painless, lose a random extremity if you take 3 damage
5. Corpus Beetles, 1d4 Intelligence, lose a rank in a skill on a 1
6. The Dithers, 1d4 Wisdom, regularly save vs short-term memory loss
7. Black Death, 1d4 Constitution, -4 to saves vs. disease
8. Gob Rot, 1d4 Charisma, lose a tooth on 1, part of your face on a 4, 
9. Mangling Flesh, 1d4 Random, save or mutate
10. Dungeon Slough, 1d4 Dexterity, take +1 damage from all sources
11. Worm of Entropy, 1d8 Intelligence, speaks your language, desires ruin
12. Shadow Pox, 1d6 Charisma, immune to positive spells as your shadow sickens
13. Dysentery, 1d6 Strength, 1-in-6 chance to lose action each round as you soil yourself
14. Crystal Bones, 1d4 Strength, double bludgeoning and fall damage
15. Rude Passenger, 1d2 Wisdom, save vs. messy sporulation when near people
16. The Dwindling, 1d6 Strength, if you’ve taken 7 damage you shrink to small size
17. Ogre Guts, 1d3 Dexterity, lose 1 Inventory slot each time
18. Gangrene, 1d3 Constitution, take 1d8 damage each morning
19. Rabies, 1d6 Charisma, -1 Attack, +1 Damage, cannot drink water
20. Plague, 1d2 Constitution, if you die you will rise as a zombie
21. Purple Fronds, 1d3 Strength, gorgeous to look at delicate, -1 Def
22. Brain Worms, 1d4 Wisdom, experience a full hallucination 1/day
23. Tetanus, 1d4 Dexterity, 3+ damage disables your jaw then a random limb
24. Dauntledregs, 1d6 Intelligence, fail all saves vs. fear and confusion
25. Wandering Heart, 1d3 Constitution, +1d6 damage when critically hit
26. Dimensia, 1d3 Wisdom, regular geometric shapes horrify you
27. Volcanic Blisters, pops messily dealing 1 damage 1d6 times per day
28. The Hops, 1d4 Wisdom, that many frog eggs sprout from your back
29. Doom Warts, 1d3 Charisma, they pop into tiny faces and pronounce doom
30. Cordyceps, 1d6 Wisdom, bright glowing lump, get excited near predators

Random Curse:

1. Hollow Guts, tripled food requirements
2. Screaming Teeth, halve Charisma while speaking
3. Unlucky, -2 Save
4. Dog Hatred, all dogs will attack you
5. Spirit Home, a small eldritch creature lives in your skull/teeth
6. Dreamless, need +1 X needed to improve non-attributes
7. Purse Moths, lose 1d100% of your money when you enter a settlement
8. Fragile, minimum 2d6 Death Dice
9. Mute
10. Delicate Sensibilities, halve Constitution for an hour if you hear, say, or think a swear-word
11. Desolation, double damage while alone and away from allies
12. Cursed to Die in a Fire, double damage from fire
13. The Clawing Stone, double all falling damage
14. Weak Blood, automatically fail the first save against poison
15. Into the Depths, unable to swim
16. Blinded
17. The Betrayed, triple damage from any ally
18. Latent Vampirism, halve Strength in direct sunlight or other bright light
19. Crippled, half movement
20. Rabbit Instincts, halve Wisdom whenever your life is in danger
21. Magnetic Soul, all spells that travel within 20ft of you change their target
22. Endless Thirst, water, ale, beer and wine all do nothing for you
23. Slip of the Tongue. Anything you think of saying is written on your skin
24. Nervous Wreck, double Trauma gained from any source
25. Performance Anxiety, halve Dexterity while being watched
26. Evil Twin, manifests far away, knows where you are
27. The Horseman Cometh, immediately contract 3 diseases
28. Professor’s Bane, halve Intelligence if someone asks you for advice
29. Unique Diet. Can only eat turnips, violently ill otherwise
30. The Chosen. If something would randomly apply to someone in a group, it happens to you.