This paper offers a framework for understanding how management decision errors may lead to iatrogenic outcomes. Organizational iatrogenesis is the unintentional genesis of qualitatively different problems due to mistakes such as unwise intervention strategies, well-intended work on the wrong problems, or ignorance of significant correlations. Iatrogenic outcomes sometimes involve "black swan"(Taleb, 2007) scenarios. Three such error types are well documented in the literature: type I, or α (alpha), type II, or β (beta), and type III. Type I and type II errors form the foundation of interpreting data in statistics. Mitroff and Betz (1972) introduced type III, "error of the third kind,"a metaerror of focusing on or solving the "wrong"problem(s). We add innovation error (type IV), action errors (type V and type VI), and the cascading iatrogenic error of the seventh kind (type VII), a dangerous source of irreversible organizational iatrogenesis. While many undesirable outcomes result from uncontrollable interaction of exogenous black swans with unavoidable endogenous ignorance, many are the result of controllable endogenous factors such as poor choices, faulty tactics, poor vision, "gung-ho"attitudes toward action, lack of patience, ignorance, and faulty data analysis. Our framework clarifies for leaders where and why to drill down in the decision process to lower risk of uncontrollable iatrogenic outcomes.