he state health commissioner, Antonia C. Novello, said yesterday that poorly supervised medical residents had provided "woefully inadequate postsurgical care" to a patient who died at Mount Sinai Hospital on Jan. 13, three days after he donated part of his liver to his brother.

According to the state report issued yesterday, the patient, Mike Hurewitz, 57, a reporter for The Times Union of Albany, became progressively sicker that day. He vomited blood, inhaled it and choked to death at 3:40 p.m. while he was in a transplant unit in which 34 patients were being cared for by one inexperienced first-year resident.

The resident told state investigators she was "overwhelmed" by having responsibility for so many patients, with nurses but no other physicians present to help her.

Mount Sinai is considered a leader in the field, having performed about 100 live-donor liver transplants with adult recipients, more than any other hospital in the country.

The hospital will be fined a total of $48,000, the highest penalty allowed by law for the 18 deficiencies found by state investigators. It will be banned for six months from doing live-donor liver transplants.

The recipient, Adam Hurewitz, 54, a doctor on Long Island, is out of the hospital and said to be doing well.

Details of the report were described yesterday by The Times Union, which received a copy from Mr. Hurewitz's widow, Victoria, before the report was made public.

Dr. Novello said it was impossible to know whether Mr. Hurewitz's death might have been prevented if more senior doctors had been there. But the state is "holding Mount Sinai accountable" for inadequate care, she said, and will ban the hospital for at least six months from performing any operations in which living donors are used to provide liver transplants for adults.

The hospital will not be allowed to resume such transplants until it has given the state a plan for corrective action.

The living-donor transplants have increased in the last decade, because growing numbers of people need transplants and not enough organs are available from cadavers to save them all. But the operations raise ethical questions, because they expose a healthy person to the risks of surgery.

Barry Freedman, chief operating officer of Mount Sinai, said that the state's report was accurate and that the hospital was working to improve its staffing. He said that on the day that Mr. Hurewitz died, there were unusual staffing problems, which he did not specify.

"We have great pride in this program and great pride in the care we deliver," Mr. Freedman said. "We feel horrible."

Mr. Freedman and Dr. Nathan Kase, interim dean of medicine, said that Mount Sinai was consulting outside experts in live-donor liver transplants to help it reshape its staffing and patient care.

Dr. Novello said she would ask the New York State Transplant Council, which advises the department, to review live-donor liver transplants, and that the department would get in touch with three other state hospitals that use live donors to make sure they had appropriate care and residents were supervised properly. The three hospitals are Columbia-Presbyterian Center of New York, New York University Downtown Hospital and Strong Memorial Hospital in Rochester.

Mr. Hurewitz's widow issued a statement through her lawyer, which said, "It is my view that my husband's untimely death would have been entirely preventable had proper and timely treatment been instituted by adequately trained, experienced, and supervised personnel."

Mrs. Hurewitz also called the living-donor program at Mount Sinai "flawed from top to bottom."

The report paints a disturbing picture of the care that Mike Hurewitz received, noting, among other findings, that the surgeon who operated on him, Dr. Charles Miller, head of the hospital's transplant institute, did not come back to examine him after the surgery. Mr. Freedman said another surgeon did examine him, however. The report also said that on Jan. 12, a resident and another doctor examined him but did not check his vital signs.

The next morning, Jan. 13, when Mr. Hurewitz became nauseated and started to hiccup, he was given medicine, but doctors and nurses did not try to find out the symptoms' causes. Later another resident, unaware that Mr. Hurewitz had nausea, hiccups and rapid heartbeat, wrote in his chart that his vital signs were stable.

Then, about 1 p.m., when Mr. Hurewitz began to vomit blood, the inexperienced resident called a more senior doctor, who was at a bookstore. But when the doctor arrived, he still did not examine Mr. Hurewitz, the report said.

By 2 p.m., Mr. Hurewitz needed an oxygen mask because his blood oxygen was low. By 3 p.m., he was still vomiting, and having trouble breathing, so a nurse called the resident. At 3:10 p.m., Mr. Hurewitz lost consciousness, and resuscitation was attempted. The efforts failed, and he was declared dead at 3:40 p.m.

The cause of death appeared to be that he had inhaled large amounts of the vomited blood into his lungs. An autopsy also found an extremely unusual bacterial infection in his stomach, which may have caused the bleeding. The infection not been diagnosed before his death.

The bacteria were Clostridium perfringens, which doctors at Mount Sinai said they had never encountered in a liver donor before. The bacteria are normally found in the intestines and in soil. Some of the doctors have questioned whether a lobster dinner, brought in by Mr. Hurewitz's family the day after his surgery with a doctor's permission, may have contributed to his illness.

Mrs. Hurewitz's lawyer, Steven Samuel, said the family was conducting its own investigation and had hired Dr. Michael Baden, a former New York City Medical Examiner, to review the autopsy findings.

Mrs. Hurewitz said in an interview that doctors at Mount Sinai had pressured her into allowing them to perform the autopsy. If she had not given consent, the autopsy would have been performed by the city medical examiner's office, which requires autopsies in cases of unnatural death, but allows them to be done by other parties with the family's consent as long as the death is not a homicide.

There is no registry that tracks live organ donors and recipients, and hospitals do not have to report their results, except for unnatural deaths like Mr. Hurewitz's, which must be reported to the state.

Dr. Jay Hoofnagle, director of the division of digestive diseases and nutrition at the National Institutes of Health, said more information exists about people who receive cadaveric organs than about those who undergo live donor operations, because hospitals must give information on cadaver transplants to the United Network for Organ Sharing.

Dr. Hoofnagle said officials had considered trying to create a similar registry for live donors.