James Hughes is the false name James Zanasiu Jr came up with when he awoke from his coma in the Carson City Hospital. He claimed to be a penniless non-citizen with no family so that he didn't have to pay further hospital bills, his earlier bills having been paid by Biff Carlo. ("CS:The Meaning of Love")
The last name was probably taken from Hughes Island, a location Junior had visited recently. ("CS:The Man Who Was an Island")