Alternative to "Dying" in 4E

Use -C's On a Table for Avoiding Death with 4E to get rid of the "Dying" condition and replace it with something more interesting.

• When you attack, say what is this attack trying to do to the PC, fictionally
• When a PC hits 0 or fewer hp, make death saving throws until you hit one or until you run out
• In other words, not one per turn—just keep rolling until you get 10+ or run out
• If you run out, or if the PC is at his negative bloodied value in hp, the thing that, fictionally, the attack was trying to do happens, to its full extent, whatever that means fictionally. 
• If the PC hits a death saving throw, stop making them and have the PC roll on the table for avoiding death, linked above. 
• I use the 1d6 + negative hp method. 
• Instead of just going down and having to sit there potentially doing nothing, the player will likely still be able to contribute, just with lesser effectiveness and with increased risk that the next hit will be really really bad.
• If the player is then actually dying (fictionally) or comatose or something, roll up a new PC immediately (just take a level 1 monster and reskin it). Get that player back in the game ASAP.
• If a player rolls a 20 on the death saving throw, they DO NOT roll on the table. Instead, they can spend a healing surge immediately. Turns out they dodged/withstood the shot after all. 
• Treat injuries received in this manner as diseases per the standard 4E disease rules (check to recover after extended rest, presuming enough time has elapsed according to -C's chart). 

I did this tonight, and it worked great. Our dragonborn pally tanked a warg and a slew of goblins, got his leg bitten into (1/2 movement speed) and got his abdominal wall punctured with a gross goblin spear (dazed 1 round, sickened until healing).