Question

During an urgent care clinic shift, a physician assesses a 71-year-old retired construction worker who reports the sudden onset of severe lower back pain after attempting to lift a heavy garden planter. The physician conducts a focused musculoskeletal examination, diagnoses an acute lumbar myofascial strain, and prescribes a course of naproxen. Three days later, the patient returns to the clinic reporting that his back pain is unchanged, but he now feels persistently lightheaded and has a new, deep throbbing sensation in his mid-abdomen. His vital signs show a blood pressure of 92/58 mmHg and a heart rate of 115/min. The physician attributes the hypotension to dehydration and the abdominal symptoms to NSAID-induced gastritis. The physician prescribes oral rehydration and pantoprazole, maintaining the initial diagnosis of a lumbar strain. Later that evening, the patient collapses at home and is diagnosed with a ruptured abdominal aortic aneurysm in the emergency department. The urgent care physician's diagnostic error was primarily driven by an over-reliance on the initial history of heavy lifting, which prevented adequate adjustment of the diagnostic approach when hemodynamic instability developed. Which of the following cognitive biases does this best represent?