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STUDY DESIGN Case-control study. OBJECTIVE To analyze patient complaints, potential risk and malpractice events involving orthopaedic spine surgeons over a 10-year period. SUMMARY OF BACKGROUND DATA Unsolicited patient complaints may be associated with risk management and malpractice events. METHODS We analyzed patient complaint, potential risk event and malpractice event data for 6 orthopaedic spine surgeons over a 10-year period. Patient complaints were analyzed and classified according to the Patient Complaint Analysis System (PCAS). Baseline demographics were recorded for patients with complaints as well as the surgeons. A control group consisting of all patients seen by the 6 surgeons during the study period was created to identify patient and physician risk factors for formal patient complaints. Event rates (for complaints, risk and malpractice events) were calculated by dividing the number of events by the total number of unique patients seen. RESULTS There were 214 complaint designations among 202 patients with formal complaints, resulting in a complaint rate of 0.79%. Patients were most likely to complain about Access and Availability (35%) followed by Care and Treatment (32%). Of the 68 complaints regarding care and treatment, 34 were related to dissatisfaction with surgical outcome. Complications were identified in 26 / 34 cases. The malpractice event rate ranged from 0.06%-0.65%. Patients who had surgery (P < 0.0001) or a mental, behavioral, or neurodevelopmental disorder (P = 0.0004) were more likely to file complaints compared to the control group. CONCLUSION While infrequent, patient complaints against orthopaedic spine surgeons are most related to Access and Availability. The rate of malpractice events varies widely between surgeons.Level of Evidence: 3.