A lot of folks like death spirals for supposed verisimilitude, but I've always found them to be more trouble than they were worth.
What about non-d20 systems of dealing with damage?
Curiously, I think that that's one of the advantges of a VP/WP system, that it can bypass the buffer due to bad luck. Not enough to get me to abandon HPs, which I think are only problematic if there are too many of them (i.e., I'm more concerned with how you generate and accumulate HPs than I am with how they operate in game) because HP are just too simple for me to really turn away from them. But I'm curious why you think bad luck is lacking in verismilitude. In my experience, that's actually quite realistic when mapped to real people and real injuries. There's all kinds of "luck" or chance or whatever you want to call it... randomness, at least... involved in how serious an injury is from almost any type of source.
Niccodaemus, how much do you feel that your system slows down gameplay?
Like what, he asked with genuine curiousity. I don't pretend to be a roleplaying connoisseur, but I've seen my fair share of systems. Most of the ones I've seen either have some variation on the damage save mechanic, or the hit point mechanic. In fact, I'm struggling to think of any that weren't conceptually either one or the other.If you allow bad luck to bypass vitality, then you no longer have reliable protection from sudden random death. At that point, why use a hit point mechanic at all? There are simpler, cleaner ways of handling injury, with less arithmetic and more believability.

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