Before game 5, Akagi himself destroys the 1,400 cc of blood he had lost so far.
The game reaches East Hand 4, where initially it looks like luck is in Akagi's favor.
But just before that hand ends in a draw, Yasuoka makes the terrible mistake of shifting the drawing order. Thus Washizu gets a haneman tsumo win, causing Akagi to lose 600 cc of blood. Combined with the 1,400 cc of blood he has already lost, it's exactly the lethal amount of 2,000 cc. Ougi and Yasuoka can't do anything but watch Akagi have his blood extracted...
The heavens just commanded 
me to carry out your execution.
Der Himmel hat mir befohlen,
dich zu exekutieren.
Los Cielos me ordenan impartir su justicia.
Los Cielos me ordenan impartir su justicia.
Le ciel a ordonné son exécution.
I Cieli mi hanno ordinato
di fare giustizia.
Os céus me mandaram 
fazer a justiça prevalecer.