Copy the GTA_IV_Patched.pkg file to the root of your USB drive. Ensure the file is not split (if over 4GB, use a splitter tool or an NTFS drive with IRISMAN).
The term "GTA IV PKG Patched" refers to community-created, modified installation packages. These are not official Rockstar updates. They aim to solve specific flaws in the official digital release. gta iv pkg patched