A report on deaths in District-funded facilities for the mentally retarded concludes that most residents died of natural causes, but critics say the review failed to identify serious care problems in group homes that contributed to some fatalities.

The review found that there had been 89 deaths over a three-year period, from 2001 to 2003. Autopsies on 83 of the deceased attributed the deaths to a range of medical conditions, including neurological, cardiovascular and gastrointestinal diseases and cancer. Six deaths resulted from traffic accidents, a fall or choking on food.

The report, done by order of Mayor Anthony A. Williams (D), contains statistical data on all the fatalities, including numbers, ages, sex and race. But it does not provide information about circumstances leading to the deaths, and advocates for the mentally retarded said the review is misleading.

One woman, who never received a mammography during her stay at a group home, died of breast cancer, according to the advocates. One man, totally dependent on others for food and water, died of dehydration. A third ward of the city died because of an overdose of medication -- a death for which the District is being sued.

"Naturally you will die if you have a problem that goes untreated, but that's not a natural death," said Kelly Bagby, legal director of University Legal Services, which runs a federally mandated advocacy program for the mentally retarded. "The report is not an adequate monitor of what is happening. . . . People are still dying, and the District is not learning anything or taking significant action."

Bagby cited another report, issued this month in a long-standing federal suit against the District over care of the mentally retarded, that flagged continuing problems with health care and other services.

The report on the deaths was in response to the mayor's 2001 order creating the Mental Retardation and Developmental Disabilities Administration Fatality Review Committee. He specified that it was to issue annual reports, with both statistical data and an analysis of whether "any pattern of factors" caused or contributed to the deaths. No reports were filed, however, until the one last week.

Lori Parker, special assistant to Neil O. Albert, deputy mayor for children, youth, families and elders, said the mayor's office is studying the report and preparing a response. "The goal is to make sure that service delivery does, in fact, improve," she said.

Debra Daniels, a spokeswoman for the Department of Human Services, said the committee compiled the data "and reported the facts. . . . This was not a situation where the committee was to get into what was going on at the group homes. If additional information needs to be reported or investigated, that certainly will be made clear to the committee."

Marie Pierre-Louis, the acting medical examiner whose office performed the autopsies, said through a spokeswoman that she would need more time to respond to questions about individual cases.

Joseph Cammarata, whose law firm has represented families of residents who died in group homes, said the fatality report was useless without more details.

"How is this report going to help the mayor do better for the city's most vulnerable group of citizens if it just says there were X number of deaths?" said Cammarata, who is handling the pending case of Roger Whitfield, 22, who died in 2001 of an overdose of fluvoxamine, a drug he was given to control behavior.

The District is the defendant in a 28-year-old federal lawsuit that centers on the quality of care for the retarded and developmentally disabled, many of whom also have severe physical disabilities. A hearing on that suit is scheduled for today in U.S. District Court.

The court monitor in the case, Elizabeth Jones, issued a quarterly report this month that criticized much of the city's effort to implement a comprehensive health care plan and other services for its mentally retarded clients.

Jones praised the personal attention and knowledgeable staff in most homes and credited the mental retardation administration with "diligent oversight" in the case of a problem residential care provider. But she voiced concerns about health risks in homes, particularly nursing care, and cited "weaknesses" that included lack of documentation in medical care, failure to keep medical appointments and lack of communication between homes and day-care programs.

Jones also faulted the mental retardation administration's investigative unit, saying that probes of serious incidents were not thorough or timely enough. Agency officials said they had just gotten the monitor's report and had not had time to respond.