>>536448380
Toriel is the one dying in the hospital instead of Rudy.
This negatively affects
Kris
Asgore
Asriel
Susie
Alphys
Sans (he can't befriend her in the hospital)
Rudy
and everyone else in hometown with the possible exception of Carol, I have no idea if that woman likes Toriel or not. It is a simple role swap that makes almost the entirety of hometown worse as a result.