Hey,
The problem is likely that the in-game post-match summary can be misleading. The medal requires 40 final blows against enemy combatants, while the summary shows final blows plus assists, making it seem like you should have gotten the medal.
Looking at your recent matches:
https://destinytracker.com/destiny-2/profile/xbl/XvP%20Elite/matches
In the ones where you haven't died, you've had less than 40 final blows.
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That makes sense now, I hadn't realised that the final scoreboard counts assists as kills too. Thanks for your help