Yeah… that looks like a bug. It seems to occure with the “Airbrush” option activated - random dabs simply ignore* the canvas rotation. I can replicate it with a very simple brush even without tilt, i.e. with a fixed angle.
*) or better: take into account - which isn’t desired.
Well, now you have the honor to write a bug report, because without the developers knowing about it, nobody will care about it anytime soon…
You can open a bug report on https://bugs.kde.org/ - in case you would like to see it fixed. This is an interesting experience if you haven’t done it yet. You have to open an account there first, you need a valid mail address, preferably one that can be seen by the public, because that’s what it will be.
Furthermore, it is expected that you describe the error, how it occurs or could be “provoked”, what you would expect as normal behavior, and how you imagine it to be fixed. A detailed list of what is expected from a bug report can be found here: ⚓ T7492 How To Report a Bug also here is an explanation: 2. User Guide — Bugzilla 5.0.4+ documentation