Medvedev, who was the ATP Finals champion in 2020 and runner-up in 2021, lost his composure after a string of double faults in the first set as Fritz beat the Russian for the first time in his career.
The victory was also the 50th for US Open finalist Fritz in 2024 and his eighth top-10 win of the season.
"I definitely felt like at 5-3 (in the second set) he was going to reset and try as hard as he could to break me and I just had to kind of tell myself, 'He's not going to just be done with the match'," the 27-year-old said.
"It's very easy sometimes when someone's doing that to kind of relax and think that they're just going to be done and then you drop your level.
"I just had to try to tell myself to stay focused at 5-3 and play a really good game because he was going to fight for that game. Luckily, I served a great game."
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