Naruto Shippuuden Episode 159

[Azonalanthious]

I felt that Tsunade's reaction to when she tried to heal Kakashi with the slug was fairly conclusive to me that he had died. If he had only been "near death" she wouldn't have sent it away without doing anything to him.

I see your point, but it came across to me a little different (maybe because I've got both military and medical backgrounds). I never really 'thought' about that point but I just assumed it was triage - Sakura's green/yellow/red stuff. Those injured who will live even without help, those who might survive with help, and those who will probably die even with help. In a battle situation you always devote most of your efforts to the middle category. I figured Tsunade just put in him in the final (probably gonna die) category, which matches up with the critical condition point in my earlier post, rather then it being that he was already dead.

Alternately (and I just thought about this as I was typing this post) - Kakashi is in the condition he is in because he completely and totally exhausted his chakra, right? Do we even know if that can be healed by medical jutsu? Its not an actual 'wound' after all and I don't think we've ever seen any evidence that medical jutsu can transfer chakra or anything similar. And her reaction could very easily be to a critical ninja being taken out of the fight so early, even if he isn't dead.\

Edit: Oh, and Tsunade's in person response came across to me as a very angry "Damnit, I know I could save him if I went, but I've got bigger responsabilities." Given how weepy/sad we've seen her get over the death of those she cares about, I would expect a lot more grief and a lot less anger out of her if he was already dead rather then just critical.