People having problems with the patch are the cause... not Bethesda. They've modified their .ini files to tweek the game how they want it, or modified the game to get past the memory limits, and these changes are not interacting with the patch flawlessly. It's not "quality control" that can fix that. The only thing they could do is not allow modification, but no one wants that. People who modify their program should know that they're in for conflicts when it comes time to patch.
Better to keep your mouth closed and thought a fool than to open it and remove all doubt. Prior to 1.2, yes, I modded and tweaked my game up and down and it worked no problem. When the patch came and my game broke, I did a clean reinstall. Guess what? It was still broken. That's a fresh install, cleaned the registry keys, no mods, no .ini tweaks. Still. Broken. I get it working, and the first time I try to enter a city to make sure it's working (prior to mods and tweaks), it crashes to desktop.
Console users are experiencing problems, too.
This was an awful patch. Seems typical of games these days, though. Developers can't seem to make a patch without breaking the game all over again.