i think blood loss is kind of in the system already. If you keep chopping someone's toe in the game, for example, they will die. This wouldn't happen in real life...you cannot die from toe loss. However, if the would is deep enough can be become weak and die from blood loss. I think this is simulated in game when you can die from flesh wounds.
In game, dying doesn't really represent "dying" so to speak, but becoming incapacitated or unable to fight.
You cannot die in RL by getting smashed in the arm by a mace over and over...but you can die in the game this way. This represents becoming incapacitated until you cannot fight.