Already 118 Reviews, Only 35 Percent Positive: Emergency Room Simulator Is Stuck in a Failed Launch

Emergency Room Simulator has passed 100 user reviews without escaping its negative Steam verdict. At the time of our check on 16 August 2026, the official Steam page displays 118 reviews in total. Of those, 42 are positive and 76 are negative. Steam continues to summarise the result as “Mostly Negative”; only 35 percent of reviewers recommend the game.

That means there are almost two negative votes for every positive one. The gap amounts to 34 reviews. At the same time, the score has improved by five percentage points since the previously recorded position of 100 reviews and 30 percent positive votes. The additional reviews are therefore more favourable than the first wave, but they have not yet erased the failed launch.

The higher total makes the result more meaningful than the first handful of votes immediately after the 13 August release. It is still not a survey of every buyer. Steam only reflects users who chose to submit a review. In this case, the platform lists all 118 reviews as coming from Steam purchasers. The current ratio therefore demonstrates a clear problem among reviewing players, but it does not automatically represent the opinion of every owner.

Emergency Room Simulator is developed by Caipirinha Games and published by Aerosoft. The game promises to put us in the role of a doctor in an emergency department. We are expected to question and examine patients, document findings in their records, use CT, X-ray, ultrasound, ECG and blood tests, among other methods, and then select the appropriate treatment. The store description explicitly promotes independent decisions, realistic treatment procedures and time-critical emergencies.

Much of the criticism targets precisely that promised independence. In several of the most helpful visible Steam reviews, players describe a heavily guided sequence. They say the tablet largely provides possible diagnoses and the next examinations, while the order of tests has few consequences. Rather than independently assessing a medical situation, these users feel that the cases resemble completing a checklist.

A second recurring subject is variety. Reviewers report similar injuries, returning patients and identical tasks during the opening shifts. Others criticise a hospital environment that feels sparsely populated, missing or insufficiently visible vital signs and the controls used to move stretchers. Individual reviews also mention blocked progression, inaccessible items or problems loading and starting saved games.

These statements are user experiences, not a list of bugs independently reproduced by Simulatoren-News. Not every negative review raises the same points, and individual criticism of medical details does not amount to a complete professional assessment of the game. However, the most prominent contributions repeatedly focus on several common areas: technical stability, case variety, diagnostic freedom, atmosphere and controls.

The 42 positive reviews should not be ignored. Visible recommendations praise the basic concept, the selection of medical tools and the entertainment value of the first cases, among other aspects. However, even some positive reviewers attach requests for a career or story mode, freer diagnosis, a more difficult mode and additional cases to their recommendation. The picture is not that nobody sees potential. The majority of those who have voted so far simply do not consider the current version recommendable.

Caipirinha Games has already responded to part of the launch problems. A day-one patch initially added missing language versions. On 14 August, a hotfix followed for an issue that prevented a new game from starting. Another hotfix, version 1.0.1.1134, fixed general bugs and missing localisation according to the developer. The missions were also rebalanced so that greater variety appears earlier and new cases unlock more quickly. The notices are documented in the official Steam Community Hub.

The first updates therefore address two specific areas of complaint: technical blockers and the slow introduction of more varied missions. The rise from 30 to 35 percent positive reviews could be an early sign that later buyers or players who tried the game after the hotfixes are judging it more favourably. However, the period under examination is still too short to establish a durable upward trend, and the review total continues to change.

The complaints that cannot be resolved with a single hotfix are more difficult. Greater freedom in choosing examinations, meaningful consequences for medical decisions, a livelier emergency department and a more extensive career structure concern the fundamental game design. The hotfix notes published so far do not name specific additions in these areas. The future will therefore depend not only on whether bugs disappear, but also on whether Caipirinha Games deepens the simulation itself.

The current Steam rating is consequently more than a brief technical stumble, but it is not yet a final verdict on the game’s future. Users can change their reviews after updates, and the first three days already show a slight improvement in the positive share. At the same time, the starting position remains clear: 76 negative reviews cannot be explained solely by isolated launch bugs when the most prominent criticism repeatedly addresses scope and player agency as well.

Emergency Room Simulator therefore faces two separate tasks. First, the existing cases must work reliably. After that, the game needs to demonstrate more convincingly why we are the doctors in this emergency department rather than merely the people carrying out the next displayed instruction. Whether the rating continues to rise will depend on how visibly both issues are addressed – and whether the current 35 percent approval genuinely develops into a lasting recovery.