I just applied ESXi510-201303001 and the issue remains.
Now the host takes a long time to start up, temporarily hanging on starting the usbarbitrator service.
http://hostilecoding.blogspot.com/2013/02/esxi-51-stuck-on-running-usbarbitrator.html
The host does come up eventually, but the DirectPath I/O Configuration still says I need to reboot to take effect.
VMware should really try to fix this - it's been about a year now.
