This is a combination performance / usability problem but I'm filing it as usability because the usability is due to slightly poor performance.
When using Alt-Enter to show R# Smart Tags for Quick Fixes after having moved my cursor to a line highlighted in gray (generally a explicit constructor of an event handler is not required or an unneccesary namespace qualification), I hit Alt-Enter to bring up the smart tags to perform the remove redundant qualifier or remove unneeded explicit constructor and generally I'll only see the options for suppressing these warnings or changing warning severity. If I wait another second and show the smart tag, I'll see the correct options and the refactoring works just fine.
It's a slight hiccup in my work flow and becomes annoying in situations with more than three lines of similar code I'd like to eliminate.
I'd expect either that the option should be there as soon as I move into the line and hit alt-enter or that it should be added to the list momentarilly and I shouldn't have to hit escape, wait, and alt-enter again to see it if I queried it too quickly.