They have eliminated anything that's basically a single save vs. death.The early 4e hype said they would eliminate Save or Die effects. Have they? In that case, are there no powers like disintegration? And how do medusas work without petrification? Just looking for some clarification.
In 4E saving throws are just a 50/50 duration check for a condition as opposed to a saving throw in the "traditional" sense.
There was a cool alternate magic system to the Iron Heroes game a few years back, written by a guy named Harry Pratt. It had a version of disintegrate that just dealt a lot of damage, with a note that any creature reduced to 0 or fewer hit points by the spell was reduced to dust. That more than suffices for disintegrate.
And if you meet a medusa in a situation where you for some reason can't go back to town for a ritual to de-stone the victims (I'm looking hard at a certain published adventure here), some creative DM fudging will be necessary...Medusas are no longer fail a save and die...they are now...get hit on the bad guys turn then fails two saves and die.
Not really that different.

(Dungeons & Dragons)
Rulebook featuring "high magic" options, including a host of new spells.