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Here are the rules for damage taken while at 0 HP (Player’s Basic Rules Version 0.3, Page 76):

Damage at 0 Hit Points. If you take any damage while you have 0 hit points, you suffer a death saving throw failure. If the damage is from a critical hit, you suffer two failures instead. If the damage equals or exceeds your hit point maximum, you suffer instant death.

And on Page 75 are the following Instant Death rules:

Massive damage can kill you instantly. When damage reduces you to 0 hit points and there is damage remaining, you die if the remaining damage equals or exceeds your hit point maximum.

For example, a cleric with a maximum of 12 hit points currently has 6 hit points. If she takes 18 damage from an attack, she is reduced to 0 hit points, but 12 damage remains. Because the remaining damage equals her hit point maximum, the cleric dies.

This means that even if you have more than 0 HP before you take the damage, such a hit is treated the same as the rule on Page 76 for damage taken while at 0 HP, at least as far as instant death is concerned.

So would this mean that if you take damage reducing you to 0, and there is still more damage remaining from that hit (but not enough to kill you outright), you would also immediately suffer a failed death saving throw? An example: you have 5 HP, and suffer a hit worth 6 damage, reducing you to 0 HP plus 1 remaining damage. Do you suffer the failed death saving throw in this instance, or do you only suffer the failure if you receive damage when you had 0 HP before any damage was dealt?

I researched this question but was not satisfied that this particular aspect of the rule was clarified there. That question contains an assumption that the scenario I've described does not result in a failed death saving throw ("I assume it won't, like the first hit that brings you to 0 hit points"), but my interpretation of the rules doesn't seem to come to that conclusion, or perhaps I'm misinterpreting?

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3 Answers 3

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No, you do not drop to 0HP, fall unconscious, and take a failed death save.

When you are reduced to 0HP one of two things happens: you fall unconscious or you die outright. There is no "excess" damage to worry about, excepts insofar as it concerns the "instant death" rule.

We can know this by going back one page earlier:

A creature's current hit points can be any number from its hit point maximum down to zero....

Whenever a creature takes damage, that damage is subtracted from its hit points. (PHB p.196, "Hit Points")

So let's consider the hypothetical in your question: your character had 5hp, takes 6 damage, and so is at 0HP (by rule: current HP is a non-negative number). The amount beyond what would have put her at 0HP is less than her max HP, so she does not die instantly. But there's no "excess" to worry about: all 6 damage were already dealt, and the result was to knock her current HP to zero.

She is unconscious and is now vulnerable to death saving throws, either from taking more damage or from starting turns at 0HP.

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    \$\begingroup\$ It might help you understand if you recognize sources of damage as separate instances of damage. A single instance cannot drop you to zero AND give you a failed death saving throw. However, multiattack, which can be separate instances, can knock you to zero and then attack again for a failed saving roll \$\endgroup\$ Mar 17, 2016 at 14:32
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No.

These are two cases, not the same case.

Case 1: You have 5 HP and suffer 6 damage, bringing you to 0. You are knocked out. The left over was dealt while you were at 5 HP, it isn't being damaged while at 0. The overage only matters if it is greater than your max HP. You don't fail a saving throw, RAW.

Case 2: You are already at 0, and you take new damage. Then, you automatically fail a death saving throw.

5e is very forgiving with death, and if you want death to be a bigger threat you can certainly house rule it.

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  • \$\begingroup\$ The idea that the remaining damage is still damage that was dealt while I was at 5 HP (in your example) probably explains most clearly and understandably to me why you wouldn't suffer a failed saving throw. Is this the reason why the "massive damage / instant death" rule is actually listed twice in the rulebook? Because they actually represent 2 different rules (that are closely related and appear to have approximately the same effect), but one version deals with excessive damage beyond taking you down to 0, the other deals with a certain amount of damage while you were already at 0? \$\endgroup\$
    – callahan09
    Mar 17, 2016 at 4:02
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    \$\begingroup\$ Yes, there are two different situations there, though I think they can be boiled down into once concept. One that says if you area at 0 and take X damage (where X is your maximum HP), you die. The other says you are at > 0 HP, and take (X+C) damage (where C is your Current HP, and X is your maximum HP) and then you die. \$\endgroup\$
    – rStyskel
    Mar 17, 2016 at 14:42
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Damage at 0 Hit Points. If you take any damage while you have 0 hit points, you suffer a death saving throw failure.

When you took damage, you had more than 0 hp. Stop reading. QED.

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